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
| Autor: | Diriba Teshome, Simegnew Kibret, Metages Hunie, Efrem Fenta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
OR
Odds Ratio Post-dural-puncture headache Nausea IV Intravenous Analgesic VAS Visual Analogue Score SR Systemic Review Dexamethasone Severity law.invention Post-dural puncture headache MD Mean Difference 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Systematic Review / Meta-analysis business.industry Incidence (epidemiology) Incidence General Medicine SD Standard Deviation CI Confidence Interval 030220 oncology & carcinogenesis Anesthesia Vomiting MA Meta-analysis 030211 gastroenterology & hepatology Surgery medicine.symptom business Complication medicine.drug |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Background Post-dural puncture headache is a common complication after spinal anesthesia for women who undergo cesarean delivery. Intravenous (IV) dexamethasone has been used to reduce the incidence and severity of PDPH with controversial results. This Systemic review and meta-analysis aimed to assess the effects of IV dexamethasone on PDPH. Methods This study is reported as per Preferred Reporting Items for Systematic and Meta-analysis. The primary outcome was the incidence and severity of PDPH. The secondary outcome variables were the postoperative total analgesic requirement and incidence of nausea and/or vomiting. Twelve randomized controlled trials with a total of 1548 women were included. Results Intravenous (IV) dexamethasone had no effect on the incidence of PDPH (OR = 0.64; CI, 0.39 to 1.05; I2 = 71%, P = 0.08). Intravenous dexamethasone did not show a significant difference in the incidence of PDPH at 24 h at 48 h, and within one week postoperatively with p-values of less than 0.05. In a random-effect model, a pooled analysis showed that IV dexamethasone had no effect on the severity of PDPH in VAS (MD = 0.78; CI, −2.27 to 0.71; I2 = 98%, P = 0.30). Conclusion Intravenous dexamethasone failed to decrease the incidence and severity of PDPH in women who underwent cesarean delivery under spinal anesthesia. Highlights • PDPH is one of the unwanted complications of spinal anesthesia. • Intravenous dexamethasone failed to decrease the incidence of PDPH. • Intravenous dexamethasone failed to decrease the severity of PDPH. • Intravenous dexamethasone failed to decrease the analgesic consumption. |
| Databáze: | OpenAIRE |
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