Comparing the Effect of Paracetamol, Dexamethasone, and Paracetamol plus Dexamethasone on Prevention of Postoperative Headache in Pregnant Women Undergoing Cesarean Section with Spinal Anesthesia

Abstract

Background: This study aimed to compare the effect of paracetamol, dexamethasone, and paracetamol plus dexamethasone on prevention of postoperative headache in pregnant women undergoing cesarean section with spinal anesthesia. Methods: In this clinical trial study, 220 pregnant women who were candidate for cesarean section under spinal anesthesia were randomly divided in 4 groups of 55 receiving 1 g paracetamol, 8 mg dexamethasone, 1 g paracetamol plus 8 mg dexamethasone, or the same volume of normal saline. The incidence of postoperative headache were compared between the 4 groups. Findings: 6 hours after the operation, frequency of postoperative headache in the paracetamol, dexamethasone, paracetamol plus dexamethasone, and control groups was 23.60, 20.00, 10.90, and 40.00 percent, respectively (P = 0.004). 12 hours after the surgery, these amounts were 25.15, 20.00, 10.90, and 40.00 percent, respectively (P = 0.004); and 24 hours after the surgery, they were 21.80, 20.00, 10.90, and 34.50 percent, respectively (P = 0.027). Conclusion: Using combination of paracetamol plus dexamethasone is more effective. Considering low effect of paracetamol for prevention of postoperative headache and also side-effects of high dose of dexamethasone, it seems that using combination of the two drugs is better for prevention of postoperative headache.

Keywords

• Postoperative complication
• Headache
• Paracetamol
• Dexamethasone