Does a preoperative caffeine tablet affect the characteristics of post-dural puncture headache in caesarian section under spinal anesthesia?

Background: The current study aim was to evaluate the effectiveness of administering caffeine tablets before surgery in preventing post-dural puncture headache (PDPH) in adult patients who underwent cesarian delivery with spinal anesthesia (SA). Methods: This randomized controlled study (RCT) enrolled patients aged 18–45 years who underwent elective caesarian section under SA. Patients were allocated to receive either a caffeine or placebo tablet prior to SA. Those in the intervention group received a 200 mg caffeine tablet, while those in the control group received a placebo. The primary outcome measured was the incidence of PDPH, with secondary outcomes including the severity of PDPH, associated complications, and any side effects observed. Results: The incidence of headache was significantly diminished in intervention group Ⅱ (5.1%) compared with control group Ⅰ (23.1%) (P < 0.05). The onset of headache was similar in both groups but it was delayed in caffeine group (1.33+1.52 days) versus (1.22+0.66 days) in placebo group. The median VAS for headache severity was not statistically different between both groups over all time points starting from the 24 hours to 7th postoperative days. There were insignificant adverse events of the studied drugs happened during the initial 48 hours postoperatively. Conclusions: Preoperative ingestion of 200 mg caffeine tablet was accompanied by a low incidence of PDPH.