Comparison of the Effect of Dexamethasone, Acetaminophen, and Normal Saline on the Prevention of Headache in Patients under Elective Cesarean Section

Abstract

Background: One of the most prevalent problems in patients under surgeries with spinal anesthesia is postoperative headache; despite several studies, no optimal method is recommended for prevention of this problem. This study aimed to compare the effect of dexamethasone, acetaminophen, and normal saline on the prevention of headache in patients under elective cesarean section. Methods: In a clinical trial study, 135 patients under cesarean section were randomly divided in three equal groups. 15 minutes before the termination of surgery, patients received 8 mg dexamethasone, 1 g acetaminophen, or the same volume of normal saline, respectively. The incidence and intensity (visual analog scale or VAS) of headache after spinal anesthesia was compared between the three groups. Findings: The mean headache intensity was 8.3 ± 7.4, 11.1 ± 2.9, and 19.3 ± 5.7 in dexamethasone, acetaminophen, and normal saline groups, respectively, and the difference between the three groups was statistically significant (P < 0.001). Incidence of headache was 3 (6.7%), 5 (11.1%) and 9 (20.5%) in dexamethasone, acetaminophen, and normal saline groups, respectively, and no statistically difference was seen between the groups (P = 0.140). Conclusion: Preemptive dexamethasone and acetaminophen had a considerable effect on the prevention of post-spinal-anesthesia headache but there is not any difference between dexamethasone and acetaminophen. As using dexamethasone in some patients is limited and may lead to some complications such as hyperglycemia, hormone abnormality, and gastrointestinal bleeding, using acetaminophen is proffered.

Keywords

• Headache
• Spinal
• Anesthesia
• Cesarean section