Impact of Use of Caffeine Supplements to Treat Post Dural Puncture Headache (PDPH) in Kigali city hospitals/Rwanda “descriptive/cross-section study”

Abstract

Background: The post-dural puncture headache (PDPH) is a severe complication that occurs after spinal or epidural anesthesia. It is a clinical diagnosis and presents with severe frontal headache and posterior headache involving the neck and shoulder. The PDPH may increase the severity, duration of postoperative pain, increase hospital stay, and increase hospital costs. The gold standard of management of PDPH is epidural blood patch (EBP), but when it is not available and contraindicated, other measures are taken. Those measures include no pharmacological and pharmacological, and among pharmacological include caffeine. The study aimed to reveal impact of caffeine supplementation on PDPH in postpartum women who underwent c/sections. Method: This study was a descriptive/cross-section study among women, post spinal anesthesia after C-sections and present with signs of PDPH. Statistical significance was measured with a p-value of 0.05. Study population and period: The study population included 67 women who had C-sections under spinal anesthesia and presented with signs of PDPH, and those who accepted to consent for participation in the study and fulfill the inclusion criteria. The study was conducted from November 2020 to March 2021. Results: The study finally recruited sixty-seven women with PDPH. Before caffeine supplements being taken, 21 patients representing 31.3% had mild headache, 32 patients representing 47.8% had moderate headache while 14 patients representing 20.9% had severe headache However, 24 hours after taking caffeine supplements, 51 patients representing 76.1% had no pain, 13 patients representing 19.4% had mild pain, and 3 patients representing 4.5% had moderate pain, while no patient reported severe headache. Conclusion: The management of PDPH with caffeine supplements in this study showed great improvement on headache intensity with no previous studies in Rwanda.