Effect of Gabapentin Premedication on Post Dural Puncture Headache in Patients Undergoing Elective Cesarean Section

Abstract

Background: Background: Gabapentin has widely been used to treat different types of headaches and as prophylaxsis against migraine. We aimed to access utility of pre-operative Gabapentin on characteristics of Post dural puncture headache (PDPH) in parturient patients undergoing elective cesarean section under spinal anesthesia. Methods: A double blind study was conducted on100 parturients between the age group of 18 35 yrs with ASA II undergoing elective cesarean section under spinal anesthesia randomized to receive preoperative (group G) gabapentin 600 mg (2 capsules of 300mg each) or (group P) placebo (similar looking multivitamin), with a small sip of water 2 hours before admission to the operating room. Mothers were observed for hemodynamic variabilties, side effects, sedation score, VAS score intraoperatively as well as postoperatively till discharge. Babies were followed up by Apgar scores at 1min and5min, breastfeeding difficulties, and need for NICU admission. Any possible adverse events of gabapentin as sedation, ataxia, tremors, dizziness, nausea, and vomiting were recorded for 24 hours post-operatively. Results: The incidence of headache and co-existing symptoms were similar in both groups. The onset of headache was significantly delayed in gabapentin group (P < 0.05). Also, severity and duration of headache were significantly less in gabapentin group (P < 0.05). The consumption of breakthrough analgesics in the form of caffeine and diclofenac was significantly less in gabapentine group. The incidence of sedation was more in gabapentin versus placebo group. Neonatal outcomes were statistically insignificant between both groups. Conclusion: Gabapentin given pre operatively has no effect on incidence of (PDPH) but does delays its onset and reduces its severity as well as duration in parturients undergoing cesarean section with spinal anesthesia without any significant adverse effects either on the mother or the baby.