Background: Spinal anesthesia for Caesarian sections can lead to post-puncture headache (PPH). Neostigmine/Atropine and aminophylline are potential PPH treatments. PPH results from CSF leakage causing intracranial hypotension. Pharmacological options, including Aminophylline and Neostigmine/Atropine, offer innovative approaches to PPH management. Objectives: To compare between aminophylline and neostigmine/atropine in prevention of PPH . Patients and methods: The study included 50 female patients (ages 18-40, ASA I and II) undergoing spinal anesthesia. They were divided into two groups: Group I received aminophylline, and Group II received neostigmine plus atropine. Data on heart rate and blood pressure were collected before and after anesthesia induction. Postoperative monitoring included pain scores until reaching a VAS score ≤ 3. Results: The mean age of patients was 30.5 ± 8.8 years. Most patients (84%) were ASA I. Both groups had similar age distributions (P = 0.6) but slightly higher mean age in Group 1 (31.1 ± 9.9 years) compared to Group 2 (29.9 ± 7.9 years). No significant difference in ASA classification (P = 0.440). VAS scores differed significantly (P = 0.013) with neostigmine plus atropine group showing better scores. Nausea and vomiting incidence differed significantly (P = 0.018), with 40% in Group 2 and 12% in Group 1. Hemodynamic stability was similar (P = 0.203) with all Group 2 and 88% of Group 1 patients being stable. Conclusion: Neostigmine plus atropine provides better pain relief during spinal anesthesia for cesarean sections compared to aminophylline but may increase nausea and vomiting, requiring careful consideration in clinical decisions.
Ahmed, A. A., Atta, N. E. M., & Soliman, M. A. (2025). Comparison between Aminophylline & Neostigmine/Atropine in Post Puncture Headache of Spinal Anesthesia in Caesarian Section. SVU-International Journal of Medical Sciences, 8(1), 730-740. doi: 10.21608/svuijm.2023.230386.1659
MLA
Abbady Abdellah Ahmed; Nagat Ebied Mohamed Atta; Mohamed Abdelrahman Soliman. "Comparison between Aminophylline & Neostigmine/Atropine in Post Puncture Headache of Spinal Anesthesia in Caesarian Section", SVU-International Journal of Medical Sciences, 8, 1, 2025, 730-740. doi: 10.21608/svuijm.2023.230386.1659
HARVARD
Ahmed, A. A., Atta, N. E. M., Soliman, M. A. (2025). 'Comparison between Aminophylline & Neostigmine/Atropine in Post Puncture Headache of Spinal Anesthesia in Caesarian Section', SVU-International Journal of Medical Sciences, 8(1), pp. 730-740. doi: 10.21608/svuijm.2023.230386.1659
VANCOUVER
Ahmed, A. A., Atta, N. E. M., Soliman, M. A. Comparison between Aminophylline & Neostigmine/Atropine in Post Puncture Headache of Spinal Anesthesia in Caesarian Section. SVU-International Journal of Medical Sciences, 2025; 8(1): 730-740. doi: 10.21608/svuijm.2023.230386.1659
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