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- Title
Prophylactic Intravenous Injection of Neostigmine with Atropine versus Ondansetron on Post-dural Puncture Headache Incidence and Severity among Elective Cesarean Section Cases.
- Authors
EL-zayat, Hytham Ibrahim; Tawfik, Mohamed Shehta; Elattar, Hala Abdel-Sadek; Galal, Asmaa Mohamed
- Abstract
Background: Post-dural puncture headache (PDPH) is a debilitating condition that appears after puncturing the dura mater. The headache is severe, throbbing, frontal, radiates to the occiput; increases by standing, and decreases by lying down. Objectives: This study aimed to compare the effect of ondansetron compared to neostigmine on reducing the incidence of PDPH in parturients undergoing spinal anesthesia for elective cesarean section. Methods: Fifty-one parturients undergoing spinal anesthesia for elective cesarean section were allocated randomly into three equal groups; Group (n = 17) parturients received intravenous injection of 0.9% normal saline after delivery of the fetus as controls, Group (n = 17) parturients received intravenous injection of neostigmine and atropine after delivery of the fetus, Group (n = 17) parturients received intravenous injection of ondansetron after delivery of the fetus. Results: The incidence of headache, and median of VAS was higher among controls as compared to the neostigmine and the ondansetron group. Also, were higher in the neostigmine group compared to the ondansetron group. The control group (47.1%) required significantly more post-operative analgesia than the ondansetron group (11.8%; p=0.01). The patient's heart rate increased during spinal anesthesia, but it reduced throughout delivery and after drug infusion. The occurrence of headache and median visual analogue scale score at 48 and 7 days were postpartum differed significantly among the three groups. Conclusions: Intravenous injection of 0.08 mg/kg ondansetron is more effective in lowering the incidence and severity of post-dural puncture headache compared to 20g/kg neostigmine plus 10g/kg atropine intravenous injection in parturients undergoing spinal anesthesia for elective cesarean section.
- Subjects
CESAREAN section; INTRAVENOUS injections; ONDANSETRON; ATROPINE; DURA mater
- Publication
Zagazig University Medical Journal, 2024, Vol 30, p175
- ISSN
1110-1431
- Publication type
Article
- DOI
10.21608/ZUMJ.2023.242334.2954