Authors: Maher Fawzy Mahmoud, Hassan Mohamed Ali, Mohamed Mourad Hashim, and Ahmed Abdel Kader Fahmy
Abstract: The usual practice of anaesthesia all over the world for caesarean section is spinal anaesthesia, which is associated with post dural puncture headache (PDPH) as a common complication, Intrathecal dexamethasone hypothetically will prevent PDPH due to its anti-inflammatory effect as it suppresses the inflammatory mediators released after the dural puncture. Methods: A double blinded randomized study of 444 females scheduled for elective Caesarean section were included in this study and allocated to three groups, D4 group (n=138) with 4 mg dexamethasone intrathecal, group D8 (n=151) with 4 mg intrathecal and a control group (n=155) injected with placebo. The three groups were monitored for incidence, severity and duration of PDPH. Results: PDPH developed in 24 cases (17.39%) in D4 group, 26 cases (17.2%) in D8 group and 51 cases (32.9%) in control group (p value >0.05), there was no significant difference in the incidence, severity or duration of PDPH between D4 and D8 groups (p>0.05). Ephedrine dose requirement in D4 (15.32±9.252) and in D8 (14.11±15.19), while in the control group it was (27.2±12.125) with p value<0.01 Conclusions: intrathecal dexamethasone, either 4 mg or 8 mg decrease the PDPH, but with no statistical difference, but as a secondary result it can reduce the hypotension from the spinal anaesthesia (p<0.01).