DRUG TREATMENT AND PREVENTION OF POSTOPERATIVE HEADACHE
Abstract
Headache frequently occurs after spinal anesthesia or after craniotomy, especially after removal of acoustic neuroma. Headache after spinal anesthesia is caused by leakage of liquor through dural puncture and decrease of intracranial pressure, while pain after craniotomy is consequence of operative injury of peri-cranial muscles and soft tissues.
Epidural administration of morphine and intravenous administration of cosyntropine or aminophylline at the end of a surgical intervention may prevent postoperative headache, while caffeine, gabapentin, pregabalin, theophylline, hydrocortisone or cosyntropine are efficient in the treatment. Drugs are not efficient for prevention of headache after craniotomy, while parenteral codeine and/or acetaminophen can terminate this type of pain. Non-steroid anti-inflammatory drugs should be avoided for treatment of post-craniotomy headache, due to their extra- and intra-cranial adverse effects.
Timely administration of appropriate drugs for prevention or treatment of postoperative headache significantly decreases suffering, hastens recovery and prevent chronic headache.
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