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Related Experiment Video

Updated: May 13, 2026

Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache

Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache

Published on: July 29, 2021

Drug therapy for preventing post-dural puncture headache.

Xavier Basurto Ona¹, Sonia Maria Uriona Tuma, Laura Martínez García

¹Emergency Department, Hospital de Figueres, Fundació Salut Empordà, Figueres, Spain. basurto18@gmail.com.

The Cochrane Database of Systematic Reviews

|March 2, 2013

Summary

Post-dural puncture headache (PDPH) can be prevented by certain drugs like morphine and cosyntropin, with aminophylline also showing effectiveness. However, dexamethasone may increase PDPH risk, and evidence for other drugs is inconclusive.

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Minimally Invasive Surgical Decompression of Occipital Nerves

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Dural Stimulation and Periorbital von Frey Testing in Mice As a Preclinical Model of Headache

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Published on: September 13, 2024

Area of Science:

Anesthesiology
Pharmacology
Neurology

Background:

Post-dural puncture headache (PDPH) is a common complication following lumbar punctures.
Uncertainty exists regarding the clinical effectiveness of various pharmacological interventions for PDPH prevention.

Purpose of the Study:

To evaluate the efficacy and safety of drugs in preventing PDPH in adult and pediatric populations.
To synthesize evidence from randomized controlled trials on PDPH prevention strategies.

Main Methods:

Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (CENTRAL, MEDLINE, EMBASE, CINAHL).
Inclusion criteria focused on RCTs assessing any drug for PDPH prevention, with no language restrictions.
Data extraction and risk of bias assessment were performed independently by review authors; meta-analysis was not conducted due to heterogeneity.

Main Results:

Ten RCTs involving 1611 participants, primarily women undergoing lumbar puncture for regional anesthesia, were included.
Epidural morphine and intravenous cosyntropin demonstrated effectiveness in reducing PDPH incidence compared to placebo.
Intravenous aminophylline showed a preventive effect, while intravenous dexamethasone increased PDPH risk. Spinal morphine was associated with increased pruritus, and epidural morphine with nausea/vomiting.

Conclusions:

Morphine and cosyntropin are effective in reducing PDPH, particularly in high-risk obstetric patients.
Aminophylline may prevent PDPH in patients undergoing elective cesarean sections.
Dexamethasone increased PDPH risk post-spinal anesthesia; evidence for fentanyl, caffeine, and indomethacin is inconclusive, necessitating cautious interpretation due to study limitations.