The effect of oral gabapentin on postdural puncture headache☆

Summary 

Postdural puncture headache (PDPH) has been a vexing problem for patients undergoing dural puncture for spinal anaesthesia since Bier reported the first case in 1898. Gabapentin is a structural analogue of gamma-aminobutyricacid (GABA), which was first developed as an anticonvulsant drug. In this study, we investigated the efficacy and tolerability of administration of oral gabapentin in PDPH. Twenty ASA I–II patients who developed PDPH after spinal anaesthesia were included in this study. After PDPH was diagnosed by the postural component of the pain, all the patients were treated with bed rest and fluid hydration in postoperative care. Patients were randomised to receive either gabapentin (Group 1) or placebo (Group 2). Group 1 (n=10) received 900mg/day three times a day of gabapentin 300mg (Neurontin; Pfizer) orally and the same dose was repeated every 8h for 4 days. The patients’ headaches were evaluated by using the visual analogue scale (VAS) for 4 days. Other complications such as somnolence, ataxia, light-headedness, dizziness and visual disturbances were also followed.

VAS scores were significantly lower in Group 1 than in Group 2 for the 4 days of the study. Administration of oral gabapentin in patients with PDPH after spinal anaesthesia is an effective and safe treatment.

Keywords: Spinal anaesthesia, Postdural puncture headache, Gabapentin