Zolmitriptan is effective in relieving post-dura! puncture headache in young parturients

ABSTRACT

This comparative study was designed to assess the efficacy of zolmitriptan, a triptan widely employed as first-line therapy for migraine, in relieving post-dural puncture headache in parturients who were operated for cesarian section under spinal anesthesia. The study was carried out at department of Anesthesiology, Combined Military Hospital Rawalpindi, over a period of twelve months from August 2012 to July 2013. We enrolled 60 adult parturients who complained of post-dural puncture headache in post-partum period. They were divided into two equal groups of 30 each; Group-1 [Z-group] received zolmitriptan along with other supportive treatment for spinal headache and Group-2, control group [C-group] was given only supportive treatment. Efficacy of zolmitriptan in relieving post-dural puncture headache [PDPH] was studied and frequency of complications of the drug were noted. After 6 hours, 60% patients of Z-group got relief from headache. While in control group only 36.66% patients were pain free [p 0.016]. After 12 hours, relief from headache was noted in 70% patients of zolmitriptan-group while in C-group only 46.66% were relieved [p 0.015]. After a period of 24 hours results were 86.66% vs. 63.33% [p 0.006]. After 48 hours, in Z-group 96.66% patients were pain free, while in C-group 63.33% were free from headache [p 0.001]. There was no change in results for Z-group after 72 hours. In contrast, in C-group 80% were pain free and 20% patients were still symptomatic. Borderline statistical significance was present [p 0.046]. The study revealed that anti-migraine drug zolmitriptan in combination with supportive treatment is effective in relieving PDPH in parturients