Dexamethasone Increases the Frequency of Post-Dural Puncture Headache (PDPH): An Evidence Based Reality

Dexamethasone and post-dural puncture headache in women who underwent cesarean delivery under spinal anesthesia: A systemic review and meta-analysis of randomized controlled trials

“…The results of our systemic review and meta-analysis revealed that intravenous dexamethasone failed to decrease the occurrence and the severity of PDPH in women who underwent cesarean delivery under spinal anesthesia. Contrary to this SR and MA researches done by Ona et al, Yousefshahi et al, showed that IV dexamethasone increases the occurrence of PDPH [ 26 , 27 ]. In agreement with this SR and MA studies done by Yang et al, and Mahmoud et al found that the use of IV dexamethasone has no statistically significant benefit to the occurrence and severity of PDPH [ 28 , 29 ], while some studies showed that steroids decrease its incidence and severity [ 1 , 30 , 31 ].…”

“…There were controversial results regarding the effect of intravenous dexamethasone on reducing the occurrence and severity of PDPH, which necessitates this SR and MA. Some studies showed that dexamethasone increased significantly the frequency and severity of PDPH after cesarean delivery [ 26 , 27 ], other studies dexamethasone fail to reduce the incidence and severity of PDPH in different dosage [ 28 , 29 ], while other studies show that steroids decrease its incidence and severity [ 1 , 30 , 31 ]. There were SR and MA regarding the effects of IV dexamethasone on the incidence and severity of PDPH for women undergoing cesarean delivery under regional anesthesia.…”

Effect of pre-administration with aminophylline on the occurrence of post-dural puncture headache in women undergoing caesarean section by combined spinal-epidural anaesthesia

“…9 At present, most clinicians and researchers believe that the occurrence of PDPH is related to the loss of cerebrospinal fluid and the decrease of intracranial pressure after intraspinal puncture. 11 However, the exact mechanism remains unclear and might be related to the following factors: (i) decreased intracranial pressure leading to the compensatory expansion of the intracranial blood vessels and increased blood flow, resulting in PDPH; 12 (ii) reduced intracranial pressure directly activating adenosine receptors, stimulating intracranial pain sensitive structures and causing intracranial vascular dilatation, resulting in PDPH; 13 and (iii) decreased intracranial pressure causing the brain tissue to sink and shift, thus stretching the intracranial blood vessels and the trigeminal, vagus, glossopharyngeal nerve and other cerebral nerves, resulting in the occurrence of PDPH. 14 Table 1.…”