Study Comparing Nebulized NeostigmineAtropine and Lidocaine for Treating Post-Dural Puncture Headache After Spinal Anesthesia in Women Having Elective Cesarean Sections

What this Trial Is About

Post-dural puncture headache PDPH is a common and painful complication experienced by pregnant patients undergoing cesarean sections with spinal anesthesia. This trial evaluates and compares treatments for acute PDPH using nebulized neostigmineatropine versus lidocaine, alongside standard medical care. The purpose is to find effective treatments to relieve this headache, which occurs due to cerebrospinal fluid leakage causing pain and cerebral blood vessel changes. Participants are randomly assigned to one of three groups a control group receiving saline nebulization twice daily for three days with conventional care a neostigmineatropine group receiving nebulized doses twice daily plus conventional care or a lidocaine group receiving nebulized lidocaine twice daily along with conventional care. Conventional care includes bed rest, hydration through lactated Ringer solution infusion, paracetamol every 6 hours, and diclofenac suppositories as routine post-operative pain management. During the study, participants will be monitored for headache severity using the Visual Analog Scale at multiple time points up to 120 hours post-intervention. Additional assessments include headache classification, need for epidural blood patch, and neurological and procedural complications. Transcranial Doppler ultrasound scans will be performed at different intervals to observe cerebral blood flow. The study is double-blinded and aims to complete by early 2027, with participants involved for several days of treatment and follow-up.

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.