Comparison of Nebulized Neostigmine/Atropine Versus Lidocaine in Treating Acute Post-dural Puncture Headache After Spinal Anesthesia in Women Having Elective Cesarean Section

What this Trial Is About

Post-dural puncture headache (PDPH) is a common and painful problem that can happen after spinal anesthesia in pregnant women having cesarean sections. It is caused by leakage of cerebrospinal fluid after a lumbar puncture, leading to headache due to brain tension and blood vessel changes. This trial studies the effects of nebulized neostigmine/atropine compared to nebulized lidocaine and placebo, aiming to find better treatments for PDPH in women aged 18 to 35 years undergoing elective cesarean sections. Participants are randomly assigned to one of three groups: one group receives nebulized saline as a placebo, another receives nebulized neostigmine and atropine, and the third group receives nebulized lidocaine. Each treatment is given twice daily for three days alongside standard care, which includes bed rest, hydration with lactated Ringer solution, paracetamol every six hours, and diclofenac suppositories for pain relief. The study compares these treatments to evaluate their effects on headache severity and other outcomes. During the trial, participants will be monitored through visual analog scale (VAS) scores for headache pain over three days, Lybecker headache classification, need for epidural blood patches, and complications over several days. Transcranial Doppler scans will be performed at the start and during follow-up to assess cerebral blood flow. Hospital stay length and neural complications will also be recorded. The total study period includes treatment and follow-up assessments to evaluate safety and effectiveness of the interventions.

Comparison of Nebulized Neostigmine/Atropine Versus Lignocaine in Treating Acute Post-dural Puncture Headache Following Subarachnoid Block in Parturient Undergoing Elective Cesarean Section. A Randomized, Clinical Trial.