Abstract | BACKGROUND: METHODS: Seven pharmacological therapies ( aminophylline ( AMP), dexamethasone, gabapentin/ pregabalin (GBP/ PGB), hydrocortisone, magnesium, ondansetron (OND), and propofol (PPF)), were studied in this Bayesian network meta-analysis. The primary outcome was the cumulative incidence of PDPH within 7 days. Secondary outcomes included the incidence of PDPH at 24 and 48 h postoperatively, the severity of headache in PDPH patients (24, 48, and 72 h postoperatively), and postoperative nausea and vomiting ( PONV). RESULTS: Twenty-two randomized controlled trials with 4,921 pregnant women (2,723 parturients received prophylactic pharmacological therapies) were included. The analyses demonstrated that PPF, OND, and AMP were efficient in decreasing the cumulative incidence of PDPH during the follow-up period compared to the placebo group (OR = 0.19, 95% CI: 0.05 to 0.70; OR = 0.37, 95% CI: 0.16 to 0.87; OR = 0.40, 95% CI: 0.18 to 0.84, respectively). PPF and OND had the lower incidence of PONV compared to the placebo group (OR = 0.07, 95% CI: 0.01 to 0.30; and OR = 0.12, 95% CI: 0.02 to 0.63). No significant difference in other outcomes was found among different therapies. CONCLUSIONS: Based on available data, PPF, OND, and AMP may have better efficacy in decreasing the incidence of PDPH compared to the placebo group. No significant side effects were revealed. Better-designed studies are requested to verify these conclusions.
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Authors | Ge Zhao, Guang Song, Jing Liu |
Journal | BMC pregnancy and childbirth
(BMC Pregnancy Childbirth)
Vol. 23
Issue 1
Pg. 215
(Mar 29 2023)
ISSN: 1471-2393 [Electronic] England |
PMID | 36991366
(Publication Type: Meta-Analysis, Journal Article)
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Copyright | © 2023. The Author(s). |
Chemical References |
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Topics |
- Humans
- Female
- Pregnancy
- Post-Dural Puncture Headache
(etiology, prevention & control, epidemiology)
- Cesarean Section
(adverse effects)
- Postoperative Nausea and Vomiting
(prevention & control, complications)
- Network Meta-Analysis
- Bayes Theorem
- Randomized Controlled Trials as Topic
- Ondansetron
(therapeutic use)
- Propofol
(therapeutic use)
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