Zolmitriptan is effective in relieving post-dural puncture headache in young parturients

Abstract

Objective: 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.
Methodology: 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.
Results: 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).
Conclusion: The study revealed that anti-migraine drug zolmitriptan in combination with supportive treatment is
effective in relieving PDPH in parturients.