Comparative Study of the Effect of Intravenous Dexamethasone and Hydrocortisone on the Incidence of Headache after Spinal anesthesia in Patients after Cesarean Section

Background: Headache after spinal anesthesia for cesarean section is a common and unpleasant problem. Post-dural puncture headache develops in 16%–86% of the cases after attempted epidural block with large bore needles. The present study aimed to compare the effect of intravenous dexamethasone and hydrocortisone in reducing the incidence of headache after spinal anesthesia in cesarean section. Methods: This study was a clinical trial on 216 women undergoing cesarean section in ASA class I and II. There were 72 patients in each group after the patients were divided into three groups. The first group received dexamethasone 8 mg, the second group received 200 mg hydrocortisone and the third group was given normal saline 2 ccs (as placebo). Immediately, 6, 24, 48 hours, and one week after spinal anesthesia, the severity of headache was assessed (based on a visual pain scale of 1 to 10 was classified). Results: The prevalence of headache was 41.6% (30 of 72 patients) in the placebo group, 22.2% (16 of 72 patients) in the dexamethasone group and 13.8% (10 of 72 patients) in hydrocortisone group. The difference between dexamethasone and hydrocortisone in reducing headache prevalence was not statistically significant (p=0/21). Conclusion: Dexamethasone and hydrocortisone are effective for decreasing the incidence of headache intensity. There was no significant difference in the incidence and severity of headache between two groups. These medications can not cause delayed onset of headache.