REVIEW ARTICLE
The effect of sumatriptan, theophylline, pregabalin and caffeine on prevention of headache caused by spinal anaesthesia (PDPH): A systematic review
Nazanin Amini1, Hesameddin Modir2, Safoora Omidvar1, Mansoreh Karimi Kia1, Shirin Pazoki2, Mehdi Harorani3, Rahmatollah Moradzadeh4, Maryam Derakhshani5
1 Department of Anesthesia, School of Paramedical Sciences, Arak University of Medical Sciences, Arak, Iran
2 Department of Anesthesiology, School of Nursing and Midwifery, Arak, Iran
sup>3 School of Nursing and Midwifery, Arak, Iran
sup>4 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
sup>5 Department of Anesthesiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
Correspondence Address:
Dr. Rahmatollah Moradzadeh
Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak
Iran
Source of Support: None
Conflict of Interest: None
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Spinal anaesthesia (SA) is a common method during surgery due to easy administration, rapid effects, relaxes muscles and controls pain. But, post-dural puncture headache (PDPH) is a common problem after SA that occurs in 6%–36% of SA. We assessed the effect of four common treatment drugs sumatriptan, theophylline, pregabalin and oral caffeine on prevention of PDPH. In this systematic review, all randomized clinical trials (RCTs) during January 2015 and December 2021 were searched from PubMed, Google Scholar, Web of Science, Cochrane review and Clinical Key with a specific search strategy. The article qualities were assessed by two independent authors and were screened for relevant sources based on inclusion and exclusion criteria. Moreover, the included articles data were extracted and checked for regular basis. A total of 421 articles were identified and 193 articles were removed following a preliminary review and finally, 14 articles were included in review. Overall, we identified five RCTs on the effect of caffeine, two RCTs on the effect of sumatriptan, three RCTs on theophylline, three RCTs on pregabalin and one RCT on theophylline and sumatriptan in PDPH prevention. This review supports the effects of theophylline, pregabalin and sumatriptan in the prevention of PDPH incidence and treatment of PDPH intensity, but we cannot draw the same conclusions about caffeine due to some negative results about the caffeine effect. Nevertheless, this extracted conclusion should be considered and interpreted with caution and limited generalizations due to the small number of studies, the variety of evaluated drugs and measures, the low sample size and the bias presented.
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