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Research code: 13720
Ethics code: IR.UMSU.HIMAM.REC.1404.041
1- Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran & Department of Anesthesiology, Kowsar Hospital, Urmia University of Medical Sciences, Urmia, Iran
2- Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran & Department of Anesthesiology, Kowsar Hospital, Urmia University of Medical Sciences, Urmia, Iran ,karami.t@umsu.ac.ir
3- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2- Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran & Department of Anesthesiology, Kowsar Hospital, Urmia University of Medical Sciences, Urmia, Iran ,
3- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
Abstract: (13 Views)
Background and Aims: Post-dural puncture headache (PDPH) is one of the most common complications of spinal anesthesia in women undergoing elective cesarean section, adversely affecting maternal quality of life, mother-infant bonding, and hospital stay. This study aimed to compare the effects of sedative-dose propofol and dexamethasone on the intensity and incidence of PDPH and hemodynamic changes.
Materials and Methods: This double-blind randomized clinical trial was conducted on 138 pregnant women (18-45 years, American Society of Anesthesiologists [ASA] I-II class) scheduled for elective cesarean section at Kosar Hospital, Urmia, Iran. Patients were randomly allocated to receive either intravenous dexamethasone 8 mg single dose or propofol infusion at 30 μg/kg/min immediately after fetal delivery. The primary outcome was the incidence of PDPH within the first 24 hours after surgery. Headache intensity was assessed using VAS at 9 time points (1, 2, 24 hours and days 2–7 postoperatively). Hemodynamic parameters (SBP, DBP, MAP, HR, SpO₂) were recorded at baseline and 1-, 2-, and 24-hours post-injection. Data were analyzed using Mann-Whitney U, Friedman, and Chi-square tests, as well as repeated measures analysis.
Results: No statistically significant difference was found between groups in terms of PDPH intensity or frequency at any follow-up time (P>0.05). The highest intensity and frequency of PDPH occurred at 24 hours and day 2, gradually decreasing to near zero by day 7. Hemodynamic changes were mild, self-limited, and comparable between groups with no serious adverse events.
Conclusion: Dexamethasone 8 mg IV and propofol 30 μg/kg/min did not show any clinically or statistically significant difference in preventing PDPH after spinal anesthesia for elective cesarean section. Both agents were hemodynamically safe. Emphasis on technical preventive measures is recommended.
Materials and Methods: This double-blind randomized clinical trial was conducted on 138 pregnant women (18-45 years, American Society of Anesthesiologists [ASA] I-II class) scheduled for elective cesarean section at Kosar Hospital, Urmia, Iran. Patients were randomly allocated to receive either intravenous dexamethasone 8 mg single dose or propofol infusion at 30 μg/kg/min immediately after fetal delivery. The primary outcome was the incidence of PDPH within the first 24 hours after surgery. Headache intensity was assessed using VAS at 9 time points (1, 2, 24 hours and days 2–7 postoperatively). Hemodynamic parameters (SBP, DBP, MAP, HR, SpO₂) were recorded at baseline and 1-, 2-, and 24-hours post-injection. Data were analyzed using Mann-Whitney U, Friedman, and Chi-square tests, as well as repeated measures analysis.
Results: No statistically significant difference was found between groups in terms of PDPH intensity or frequency at any follow-up time (P>0.05). The highest intensity and frequency of PDPH occurred at 24 hours and day 2, gradually decreasing to near zero by day 7. Hemodynamic changes were mild, self-limited, and comparable between groups with no serious adverse events.
Conclusion: Dexamethasone 8 mg IV and propofol 30 μg/kg/min did not show any clinically or statistically significant difference in preventing PDPH after spinal anesthesia for elective cesarean section. Both agents were hemodynamically safe. Emphasis on technical preventive measures is recommended.
Keywords: Cesarean section, Dexamethasone, Hemodynamics, Post-dural puncture headache, Propofol, Spinal anesthesia
Type of Study: Original Article |
Subject:
Anesthesiology
Received: 2026/02/18 | Accepted: 2026/05/5 | ePublished ahead of print: 2026/05/30
Received: 2026/02/18 | Accepted: 2026/05/5 | ePublished ahead of print: 2026/05/30
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