Effect of Coffee on Postdural Puncture Headache After Cesarean Section

The Effect of Postoperative Coffee Consumption on Postdural Puncture Headache and Analgesic Use in Women Undergoing Cesarean Section With Spinal Anesthesia: A Randomized Controlled Trial

The purpose of this study is to investigate the effects of postoperative coffee consumption on postdural puncture headache (PDPH) and analgesic use in women undergoing cesarean section with spinal anesthesia.

Surgical procedures are frequently preferred today. The choice of anesthesia is crucial for patient safety in surgical procedures. Spinal anesthesia is recommended in national and international guidelines and protocols. There are many reasons for the frequent preference for spinal anesthesia. Spinal anesthesia provides better pain control than narcotic analgesics in postoperative pain management, reduces systemic opioid use, and allows for earlier onset of bowel movements in the postoperative period. However, postdural puncture headache can also occur with this method.

Postdural puncture headache (PDPH) is one of the most common complications after spinal anesthesia. Current data in the literature indicate a significant incidence of PDPH.

Caffeine has a structure similar to adenosine. Therefore, it replaces adenosine by binding to the same receptors as adenosine. Consequently, caffeine can alleviate headaches through its vasoconstrictive effect. Additionally, caffeine can inhibit the synthesis of leukotrienes and prostaglandins to a limited extent. These properties suggest that caffeine may be effective in pain control. However, the effectiveness of caffeine intake in preventing PDPH has not been definitively established.

The most effective method used to prevent this complication is epidural blood patching. However, this is an invasive procedure. To avoid the drawbacks of invasive methods, reliable, practical, and cost-effective non-invasive methods should be preferred. Caffeine is believed to have a potential role in the prevention of postdural puncture headache based on its mechanism of action.

Inclusion Criteria:

• Ability to read, understand, and communicate in Turkish
• Age ≥ 18 years
• Undergoing cesarean section under spinal anesthesia
• Spinal anesthesia administered in the sitting position
• Initiation of oral intake at postoperative hour 6
• No history of physiological discomfort related to coffee consumption based on prior experience (e.g., insomnia, palpitations, headache)
• Ability to understand the study procedures and communicate adequately to provide informed consent

Exclusion Criteria:

• Patients undergoing emergency cesarean section
• Patients with a history of migraine or other types of chronic headache disorders
• Patients in whom spinal anesthesia was converted to general anesthesia.
• Patients whose oral intake was postponed for any reason in the postoperative period.
• Patients with high-risk pregnancies.
• Use of caffeine-containing analgesic medications during the postoperative period.
• Postoperative cigarette smoking.