Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

Safarpour, Ali Reza; Mehrabi, Manoosh; Tarkesh, Firoozeh; Ashrafizadeh, Hadis; Keshtkar, Abbasali; Argani, Hassan; Abazari, Danya; Amini, Afshin; Barati‐Boldaji, Reza

doi:10.5812/aapm.119674

Cited by 5 publications

(6 citation statements)

References 31 publications

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“…The protocol for this systematic review and meta-analysis was written using the guidelines of the Cochrane Handbook, registered in the International Prospective Register of Systematic Reviews (registration number: CRD42020211990), and published in a peer-reviewed journal [ 13 ]. Databases of EMBASE, Scopus, Google Scholar, PubMed/MEDLINE, Web of Science, the CINAHL Complete, and Cochrane Library-CENTRAL were searched between January 1, 1980, and June 30, 2020, using the following key search terms: “post-dural puncture headache,” “headache,” “post lumbar puncture headache,” “aminophylline,” and “theophylline.” No restrictions on publication language or study type were applied.…”

Section: Methodsmentioning

confidence: 99%

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Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

et al. 2023

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Background: Post-dural puncture headache (PDPH) is one of the most common complications in patients undergoing spinal anesthesia. The present systematic review and meta-analysis aimed to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH.Methods: Relevant studies were identified by searching the following electronic databases, without language restriction, until June 2020: Scopus, EMBASE, MEDLINE, Google Scholar, Web of Science, Cochrane Library-CENTRAL, and CINAHL Complete. Random effects models were used to calculate the standardized mean difference (SMD) and risk ratios (RRs) with 95% confidence intervals (95% CI) to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH, respectively. The Cochrane tool was used for the quality assessment of the included studies. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation method.Results: Of the 1,349 initial records, 15 met our eligibility criteria (6 studies on therapeutic and 9 on prophylactic effects). A significant reduction in the pain score was observed following aminophylline/theophylline treatment (SMD = –1.67; 95% CI, –2.28 to –1.05; P < 0.001, I2 = 84.7%; P < 0.001). Subgroup analysis revealed that the therapeutic effect was significantly higher when these agents were compared to placebo than when conventional therapies were used. The risk of PDPH after aminophylline administration was not significantly reduced (RR = 0.74; 95% CI, 0.42 to 1.31; P = 0.290).Conclusions: Theophylline and aminophylline have therapeutic, but not prophylactic, effects on PDPH.

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Section: Methodsmentioning

confidence: 99%

“…No restrictions on publication language or study type were applied. A complete search strategy is available in a previously published protocol [13]. Moreover, the reference lists of all relevant studies, theses, proceedings, and conference papers were sought to ensure that all eligible studies were included.…”

Section: Search Strategymentioning

confidence: 99%

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

et al. 2023

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“…Theophylline acts as a histone deacetylase activator, phosphodiesterase inhibitor, and adenosine receptor blocker. 8,9 However, several questions still remain unanswered, such as the best timing and the optimal dosage of aminophylline that has the most efficacy and the least adverse effects. Exclusion criteria: Hysterectomy due to malignancy, any history of allergy to aminophylline or drug components, liver dysfunction, smokers, patients with a history of arrhythmia, epilepsy, unexpected conditions such as bleeding and unstable hemodynamics, significant complications such as arrhythmia and seizures, any situations that other surgeons rather than obstetrics (urology, general surgery, vascular surgery, etc) involved.…”

Section: Introductionmentioning

confidence: 99%

“…Aminophylline consists of theophylline and ethylenediamine in a ratio of 2:1. Theophylline acts as a histone deacetylase activator, phosphodiesterase inhibitor, and adenosine receptor blocker 8,9 . However, several questions still remain unanswered, such as the best timing and the optimal dosage of aminophylline that has the most efficacy and the least adverse effects.…”

Section: Introductionmentioning

confidence: 99%

The effect of aminophylline on the recovery profile after hysterectomy: A randomized controlled double‐blinded study

Mirsadeghi,

Biazar,

Soltanipour

et al. 2023

Health Science Reports

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Background and Aims: In anesthesia practice, aminophylline is clinically used to treat bronchospasm. However, due to its antagonistic effect on adenosine, studies have recently focused on the drug's ability to enhance the recovery profile. The aim of this study was to investigate the hypothesis that the administration of aminophylline leads to better recovery after general anesthesia in hysterectomy.Methods: This randomized controlled double-blinded study, was conducted at Alzahra academic hospital in Guilan, Iran. During December 2022 to March 2023, 70 eligible women scheduled for elective abdominal hysterectomy were divided into two groups. Group A: received 3 mg/kg IV aminophylline diluted in 100 mL of normal saline and Group C: received 100 mL IV normal saline. The time to recovery of consciousness, tracheal extubation and discharge from post anesthesia care unit were recorded. In addition, heart rate, and mean arterial blood pressure were measured at 10 point times including; baseline (T0), immediately before the administration of aminophylline (T1), every 5 min until the end of the surgery (T2,T3,T4,T5,T6), and every 15 min in PACU(T7,T8,T9).Results: There was no significant difference in terms of demographic data between the study groups. Comparing the two groups, the time of ROC was shorter in Group A than group C; 5.95 ± 1.12 and 8.5 ± 1.77 for Groups A and C, respectively (p < 0.001). The extubation time was shorter in Group A than group C; 7.79 ± 1.48 and 10.55 ± 3.02, for Groups A and C, respectively (p < 0.001). In addition, the discharge time was also shorter in group A than Group C; 30.17 ± 5.24 and 37.57 ± 4.41 for Groups A and C, respectively (p < 0.001). Not serious side effects were reported among 71.4% of cases in Group A and 51.4% in Group C (p = 0.086). Conclusion:Administration of aminophylline at a dose of 3 mg/kg IV improves the recovery profile after abdominal hysterectomy without serious adverse effects.

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“…invasive treatments such as epidural blood patches. Some therapeutic agents such as gabapentinoids (10), sumatriptan (11), adrenocorticotropic hormone(ACTH) (12), aminophylline (13,14), low-dose ketamine (15), and dexamethasone (16) have been proposed for this purpose, but their results (efficacy) are conflicting (17). Two major pathophysiologic mechanisms for PDPH are cerebrospinal fluid leakage resulting in the traction of intracranial structures and compensatory vasodilation in response to intracranial hypotension (18), which causes a vascular-type headache (19).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effects of Oral Magnesium Sachet on the Prevention of Spinal Anesthesia-Induced Headache After Cesarean Section: A Randomized Clinical Trial

et al. 2022

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Background: Post-dural puncture headache (PDPH) is a common complication of spinal anesthesia. It often goes away after a few days but may be more severe in some patients and persists for weeks. Objectives: This study aimed to evaluate the effect of oral magnesium on the prevention of PDPH after cesarean section for the first time. Methods: In this double-blind, randomized clinical trial, 100 candidates for elective cesarean section under spinal anesthesia were randomly divided into 2 groups: (i) the intervention group that received 300 mg of oral magnesium powder and (ii) the control group that received starch powder. The frequency and severity of headache and amount of analgesic consumption in both groups were measured 1, 2, and 3 days after cesarean section. Data were analyzed using SPSS version 22 at 95% CI. Results: The frequency of PDPH 1, 2, and 3 days after surgery was 8% vs 24% (P = 0.029), 10% vs 26% (P = 0.039), and 12% vs 18% (P = 0.401) in the intervention and control groups, respectively. The mean and SD of pain severity was 0.52 ± 1.83 vs 1.5 ± 2.84 (P = 0.03) on the first day, 0.70 ± 2.19 vs 1.58 ± 2.86 (P = 0.05) on the second day, and 0.82 ± 2.32 vs 1.18 ± 2.62 on the third day (P = 0.43) in the intervention and control groups, respectively. Although more patients in the control group received rescue analgesia, no significant difference was seen between the 2 study groups. Conclusions: In women candidates for cesarean section, oral administration of 300 mg magnesium 2 hours before surgery significantly reduces the frequency and severity of PDPH, but its impact on reducing analgesic consumption is not significant.

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Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol

Cited by 5 publications

References 31 publications

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

The effect of aminophylline on the recovery profile after hysterectomy: A randomized controlled double‐blinded study

Evaluation of the Effects of Oral Magnesium Sachet on the Prevention of Spinal Anesthesia-Induced Headache After Cesarean Section: A Randomized Clinical Trial

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