Could Theophylline Be First-Line Treatment for Post-Spinal Puncture Headache in Postpartum Mothers?

Abstract

BACKGROUND/AIMS: Theophylline is a drug proven safe to use during the lactation period. This study retrospectively evaluates the efficacy of theophylline infusion administered under a standard protocol in the treatment of post-spinal puncture headache (PSPH) following a cesarean delivery, and discusses its role in the treatment measures in regard to its effects on the postpartum mother and infant. MATERIALS and METHODS: A total of 33 patients who underwent a designated treatment algorithm at our Algology department were included in the study. Information on patient age, level of spinal block administration, and needle diameter were recorded from the patient records. Examination findings, analgesic drugs used before the hospital admission, onset of headache following a spinal block, time from the onset until theophylline administration, number of theophylline infusions, and Visual Analogue Scale (VAS) scores before and after the treatment were questioned in headache evaluation. Regarding drug safety, changes in the blood pressure and heart rate before and after the drug administration were evaluated. RESULTS: Seventeen (51.5%) patients did not receive the additional drug treatment before our evaluation, and only received bed rest and fluid therapy. Mean standing VAS score was 6.1±1.8 before a theophylline infusion and 1.3±1.2 45 mins after the end of the infusion (p < 0.05). Infusion was administered once in 22 (66.7%) of the patients. Headache had resolved in all the 31 (93.9%) patients who arrived for an evaluation 24 and/or 48 hours after the theophylline administration. CONCLUSION: Theophylline infusion provided a rapid and effective treatment of PSPH in postpartum mothers. Despite the limitations, we believe our study contains valuable findings that may be helpful in studies on planning a “PSPH treatment algorithm” for postpartum mothers.