ORIGINAL ARTICLE
Year : 2016  |  Volume : 9  |  Issue : 3  |  Page : 387-392

Comparison of the respective effects of paracetamol, pregabalin, and their combination in the treatment of postdural puncture headache following major gynecological surgery


1 Department of Anesthesiology, Critical Care and Pain, R.G. Kar Medical College, Kolkata, India
2 Department of Community Medicine, R.G. Kar Medical College, Kolkata, India
3 Department of Anesthesiology, MGM Medical College, Kishanganj, Bihar, India
4 Department of Anesthesiology, North Bengal Medical College, Darjeeling, West Bengal, India

Correspondence Address:
Dipasri Bhattacharya
B26/10, Abhyudoy Housing, EKTP, Kolkata - 700 107, West Bengal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-7934.189104

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Background and objective Postdural puncture headache (PDPH) is a very distressing symptom after spinal anesthesia. It usually resolves spontaneously but may extend the length of hospital stay. Although there are different measures to reduce the incidence, most of the times, none of them are effective. Paracetamol is commonly used for the treatment of PDPH. Pregabalin is recently being used for PDPH with effective results. In this study, our aim was to compare the respective effects of paracetamol, pregabalin, and their combination in the treatment of PDPH. Patients and methods In total, 150 patients who had undergone major gynecological surgery under spinal anesthesia and subsequently developed PDPH (diagnosed by postdural components of the pain) were randomly allocated by using computer-generated random numbers placed in sealed opaque envelopes. The patients were allocated into three equal groups (n = 50, each group) to receive orally either a single dose of 150 mg pregabalin (group 1) or 1000 mg of paracetamol (group 2) or a combined dose of paracetamol 1000 mg plus pregabalin 150 mg (group 3). All the patients received the same drug that they had originally received, if required, and were then followed up for 4 days. A patient's headache was scored using the visual analogue scale. Results Earlier relief from PDPH and favorable adverse event profile (overall and central nervous system-related) were found in for the pregabalin–paracetamol combination compared with either of the drugs being used alone (P < 0.05). Conclusion It was concluded that the pregabalin–paracetamol combination is a better option for the treatment of PDPH compared with both of the drugs when used alone.


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