New concepts in treatment of post-dural puncture headache: Tetracosactide vs. tetrazepam

ABSTRACT

We investigated the effect of tetracosactide hexa-acetate vs tetrazepam as therapeutic agent for treatment of post-dural puncture headache [PDPH]. Thirty patients with PDPH were randomly allocated to receive either tetracosactide 1 mg IM [group A, n=15] or oral tetrazepam 1.2 mg/kg [group B, n=15]. Severity of headache [VAS scale], neck rigidity, nausea and vomiting were recorded before treatment and at intervals after treatment. The need for supplementary management as hydration, analgesics or epidural blood patch was also recorded. Our results suggest that tetrazepam has a superior effect compared to tetracosactide in controlling PDPH. It also alleviates neck rigidity and vomiting in a statistically significant way. The drug is also cheap, easy to use and has minimal side effects