Acta neurologica Belgica
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Acta neurologica Belgica · Mar 2015
Randomized Controlled TrialEffect of dexamethasone on the incidence of post-dural puncture headache after spinal anesthesia: a randomized, double-blind, placebo-controlled trial and a meta-analysis.
The effect of dexamethasone on post-dural puncture headache (PDPH) after spinal anesthesia has not been well elucidated. This randomized, double-blind, placebo-controlled trial was carried out in patients undergoing a cesarean at the Qilu Hospital, Shandong University. The subjects were randomly divided into a placebo and a dexamethasone group. ⋯ The results indicated that prophylactic administration of 8 mg dexamethasone did not have any protective effect against PDPH (31 vs. 18, P = 0.054) and even increased the incidence of PDPH in the first 24 h in parturient patients (25 vs. 11, P = 0.016). Furthermore, the meta-analysis also showed that dexamethasone did not prevent the incidence of PDPH in the postoperative follow-up days (RR 1.05; 95 % CI 0.46-2.38; P = 0.91) and may even have increased the trend in the first 24 h. Prophylactic administration of 8 mg dexamethasone does not have any protective effect against PDPH and may even increase the incidence of PDPH in the first 24 h in patients with spinal anesthesia.
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Acta neurologica Belgica · Dec 2012
Randomized Controlled TrialEffect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial.
In this study, we evaluated the effect of dexamethasone used as a prophylaxis for nausea and vomiting on the incidence of postdural puncture headache (PDPH) in pregnant women receiving spinal anesthesia for cesarean section. In a prospective, randomized, double-blind, placebo-controlled study, 372 women under spinal anesthesia received 8 mg of dexamethasone or placebo intravenously just after the umbilical cord was clamped. The rate of PDPH and correlated risk factors were evaluated. ⋯ This effect was most prominent on the first day (P value = 0.046) and disappeared on the second day after spinal anesthesia (P value = 0.678). Prophylactic treatment with 8 mg of dexamethasone not only increases the severity and incidence of PDPH, but is also ineffective in decreasing the prevalence of intra-operative nausea and vomiting during cesarean section. The treatment is a significant risk factor for the development of PDPH.
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Acta neurologica Belgica · Dec 2007
Randomized Controlled TrialLevetiracetam and bleeding disorders.
Six studies were conducted in healthy male volunteers to evaluate the effect of levetiracetam on bleeding time. In three open-label studies, a single dose of levetiracetam (250, 500, or 1000 mg, respectively) was administered 12 hours after acetylsalicylic acid (aspirin). Bleeding time increased by 3.5% to 30% relative to baseline, but the effect was not dose-related and not clinically relevant. ⋯ Except for two subjects in a crossover study, one of whom received placebo, no absolute bleeding time value was above the normal range of 4-8 minutes. These results indicate that levetiracetam does not produce clinically significant increases in bleeding time in healthy male volunteers. Further a review of clinical trials suggests that levetiracetam does not appear to cause clinically significant or relevant hematological adverse events suggestive of underlying hematological disorders.