Comparative Study Between Hydrocortisone and Mannitol in Treatment of Postdural Puncture Headache

Comparative Study Between Hydrocortisone and Mannitol in Treatment of Postdural Puncture Headache: a Randomized Double-blind Study

Fifty patients of both sex, aged 18-50 years and ASA I and II undergoing elective lower abdominal and pelvic surgery under spinal anesthesia were included in this randomized double-blind study. Patients were randomly divided into 2 groups 25 each; group (I) received intravenous hydrocortisone 100mg every 8 hours for 48 hours and group (II) received intravenous infusion of mannitol 20% 100ml over 30 minutes followed by 100ml every 12hours. Mean (+/- SD) of headache intensity at 0, 6, 12, 24 and 48 hours after beginning of treatment was assessed using visual analog scale.

Inclusion Criteria:

• aged 18-50 years old.
• both sex.
• ASA physical status I and II.
• 70-90 kg body weight.
• height 160-180 cm.
• Elective lower abdominal and pelvic surgery e.g. repair of inguinal hernia, repair of incisional hernia, varicocele and hydrocele.

Exclusion Criteria:

• Patients with impaired kidney or liver functions.
• history of cardiac or central nervous system disease.
• uncontrolled medical disease (diabetes mellitus and hypertension)
• history of intake of non-steroidal anti-inflammatory drugs or opioids within 24 h before surgery
• allergy to the used medications
• patient's refusal
• duration of surgery more than 120 minutes.