Pak. J. Pharm. Sci., Vol.27, No.5, September 2014, pp.1203-1207 1203 The effects of gabapentin on severity of post spinal anesthesia headache Sepideh Vahabi 1 , Sedigheh Nadri 2 and Fatemeh Izadi 3 1 Associated professor, Anesthesiology department, Lorestan University of Medical Sciences, Khoramabad, Iran 2 Assistant professor, Anesthesiology department, Lorestan University of Medical Sciences, Khoramabad, Iran 3 General Practitioner, Lorestan University of Medical Sciences, Khoramabad, Iran Abstract: Spinal anesthesia is a common anesthesia method and post dural puncture headache (PDPH) is one of its most common adverse effects. Gabapentin is a popular anticonvulsant drug that has been used as an oral nonopioid analgesic in recent years. In this placebo-controlled double-blind study, 120 patients were randomized in two equal groups (Placebo or gabapentin). The patients in the gabapentin group received gabapentin 300 mg orally one hour before the surgery and then every 12 hours for the first 24 hours after the surgery while the placebo group received placebos in the same way. Severity of headache and postoperative pain assessed by verbal rating score for pain (VRSP), morphine consumption, nausea, vomiting, somnolence, pruritus, dizziness in the first 48 hours, hypertension, hypotension, bradycardia and tachycardia in the first 24 hours after the surgery were recorded. In first 48 hour after surgery the mean of severity of headache in the gabapentin group was 0.20±0.05, and in the placebo group it was 0.93±0.01. The mean of postoperative pain in the gabapentin group was2.25±0.793, and in the placebo group it was3.77±0.813. In the first 24 hours post operative the mean of morphine consumptions were 0.20±0.030 and 0.32±0.0 30 mg in gabapentin and placebo groups. No significant differences were found between the two groups regarding incidence rate of the adverse effects. In this study, administration of gabapentin decreased the incidence and severity of post spinal anesthesia headache, postoperative pain and morphine consumption, without any significant differences in serious adverse effects. Keywords: post spinal anesthesia headache, gabapentin, spinal anesthesia. INTRODUCTION Spinal anesthesia (SA) is a common method of anesthesia with predictable and acceptable associated complications and its benefits are assessed individually (Ahmed et al. 2006; Stoelting et al., 2002). Hypotension, bradycardia, post SA headache, high spinal anesthesia, nausea, urinary retention, back pain, neurological damage (rare) and decreased ventilation are some of its complications (Stoelting et al. 2002). Post dural puncture headache (PDPH) is one of the commonest complications after surgery. This headache does not occur only after SA, it may occur due to myelography and diagnostic lumbar puncture (Ronald, 2005). This headache involve anterior frontal or occipital regions, become severer with sitting, improved by sleeping and sometimes is associated with diplopia due to the extension of the 6 th cranial nerve. Tinnitus and acute hearing loss may be accompanied with post SA headache. Headache without positional feature cannot be PDPH (Stoelting et al. 2002). Young ages, female gender, using larger needles, pregnancy, and frequent perforating of dura are some factors which may increase possibility of PDPH. This headache is apparently more common in pregnant women and postpartum period in comparison to general population. Using appropriate needle for spinal block and anesthesiologist with adequate skill will result in lower incidence of PDPH after cesarean section with SA (Ronald, 2005; Lubusky et al. 2006). PDPH is a complication that should not treated carelessly and potentially can lead to considerable disability and even death. In a remarkable percentage of cases it will be solved spontaneously and in some it will last for months and even years. In outpatients service PDPH may affect the choosing of SA (Stoelting et al. 2002; Turnbull and Shpherd, 2003). Treatment of PDPH is initiated with bed rest, administration of analgesics and oral or intravenous solutions (3 Lit or more daily). Whenever PDPH exists in spite of conservative treatments, it is suggested to block epidural foramen with blood in epidural space by using 10-20 ml of patient`s blood (usually from antecubital veins). The most common complications of administration of blood into the epidural space are back pain and referral pains (Stoelting et al. 2002). Gabapentin is one of the recent anticonvulsant drugs which were approved by FDA in 1993 (Azar and Nuhi, *Corresponding author: e-mail: swt_f@yahoo.com