Key result
Intravenous administration of magnesium sulfate before elective cesarean section significantly decreased the severity of post-dural-puncture headache compared to normal saline at 12 hours (VAS 1.32 vs 2.61, p=0.004) and all subsequent time points up to 72 hours.
Why the study?
Post-dural-puncture headache is a common complication of spinal anesthesia during elective cesarean delivery, and existing preventative and treatment methods are not fully effective.
Does intravenous magnesium sulfate reduce the severity of post-dural-puncture headache in patients undergoing elective cesarean section with spinal anesthesia?
RCT (n=68)
Randomly divided
No
Does intravenous magnesium sulfate reduce the severity of post-dural-puncture headache in patients undergoing elective cesarean section with spinal anesthesia?
Absolute Event Rate: 1.32% vs 2.61%
p-value: p=0.004
Intravenous administration of magnesium sulfate before elective cesarean section with spinal anesthesia significantly decreases the severity of post-dural-puncture headache.
Supports IV magnesium sulfate before cesarean spinal to lessen PDPH severity; extends evidence for its use in obstetric anesthesia.
Introduction: One of the most common complications of spinal anesthesia in elective cesarean is a headache, known commonly as post-dural-puncture headache (PDPH). Various methods are mainly recommended such as resting and the use of non-opioid analgesics, caffeine, and codeine, but none of them has been fully effective in its treatment. Hence, this study was conducted to evaluate the effect of magnesium sulfate on the prevention of post-dural-puncture headache in the elective cesarean. Method: a total of 68 patients candidate for elective cesarean and admitted to Kamali Hospital were selected using convenient sampling and they were randomly divided into two groups. One group received magnesium and other group received saline. Subjects of case group received magnesium at the dose of 50 mg / kg as bolus and the subjects of control group received normal saline at the same dose as bolus. The incidence of headache and its severity 12, 24, 36, 48 , 60 and 72 hours after surgery were measured in both case and control groups. Results: The mean age of patients in the magnesium sulfate group was 27.94 years with a standard deviation of 5.18 and the mean age of patients in the normal saline group was 29.35 years with a standard deviation of 5.97. The mean body mass index (BMI) in the magnesium sulfate group was 26.34 with a standard deviation of 4.03 and the mean body mass index (BMI) in the normal saline group was 27.15 with a standard deviation of 2.47. Post-dural-puncture headache severity was lower in the case group than that in the control group at all times (P <0.05). Conclusion: The results of this study revealed that intravenous administration of magnesium sulfate before elective cesarean in patients undergoing spinal anesthesia significantly decreases the severity of post-dural-puncture headache (PDPH).
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Ataei et al. (2020) conducted an RCT in Post-dural-puncture headache (PDPH) (n=68). Magnesium sulfate vs. Normal saline was evaluated on Severity of post-dural-puncture headache (VAS score) at 12 hours post-surgery (p=0.004). Intravenous administration of magnesium sulfate before elective cesarean section significantly decreased the severity of post-dural-puncture headache compared to normal saline at 12 hours (VAS 1.32 vs 2.61, p=0.004) and all subsequent time points up to 72 hours.
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