REVEALING EFFECTIVENESS OF EPIDURAL DEXAMETHASONE IN PDPH CONDITION

Objective: This study was held to assess the efficiency of epidural dexamethasone for preclusion of PDPH (Post Dural Puncture Headache). Study Design: An RTC (Randomized Controlled Trial) study. Place and Duration: We conducted this study for the duration of one year from March, 2018 to February, 2019 in the department of anaesthesia, Services Hospital, Lahore. Material and Method: In our study we selected 108 patients from different departments of the hospital. Equally divided them in two groups, one as study group and second as control group. In study group an intervention was done via a prophylactic dosage of epidural dexamethasone injection in a dose of 02mlwith08mg and in control group 02ml normal saline was inserted via injection at the time of anesthesia along with standard spinal anesthesia. The anesthesia was directed between L3 and L4 (03rd and 04th vertebral spaces) in sitting position. The stander dosage of anesthetic was prescribed as 75mg Lidocaine (05%) and 25mg Fentanyl by using a 25-gauge disposable needle. The prevalence of headache was the issue of our study which was assessed after spinal anesthesia in intervals as within 1st 24 hours, on 3rd day and 7th day.Results: All selected patients were distributed into two groups as study group and control group and mean age with standard deviation of the patients of these groups was as 32.18 ± 5.64 years and 31.63 ± 6.24 years. Post dural puncture headache was observed in patients of both groups as 07 (12.95%) in control group and 03 (05.55%) in study group. After 3 days of treatment, rate of headache was found considerably high in control group. On assessment of 7th day, rate of post dural puncture headache in control group was found at considerable high value as 20.38% vs 38.90% with P value less than 0.05. The mean pain score was found considerably less in study group with P value as less than 0.05 on 1st and 3rd day via comparison of mean VAS pain scores. On the 7th day assessment found no statistically considerable difference in the average pain value with P value as more than 0.05.Conclusions: According the findings of our study we found that use of epidural dexamethasone during spinal anesthesia is useful and effective for headache. Therefore, patients who suffer from spinal anesthesia might be suggested epidural dexamethasone to prevent them from headache. Key Words: Spinal analgesia, Post dural Puncture headache, Epidural dexamethasone