Aminophylline for Patients With Post-Dural Puncture Headache
Aminophylline for Patients With Post-Dural Puncture Headache
Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture. Its
 clinical manifestations are pain in the forehead and the occipital region, or diffuse
 headache. The pain is dull or fluctuating, becoming worse when standing and better when lying
 down, and is often accompanied by symptoms including a stiff neck, tinnitus, hearing loss,
 photophobia, and nausea, which cause great suffering to the patients1. According to
 epidemiological data, approximately 10% to 30% of the patients who undergo lumbar puncture
 suffer from PDPH within 48 hours of the procedure.Currently, commonly used treatments for
 PDPH include rehydration, the administration of corticotropin, caffeine, or sumatriptan, and
 the application of an epidural blood patch. The efficacy of theophylline has been proven in a
 placebo-controlled study in which 17 PDPH patients received an intravenous (IV) injection of
 200 mg theophylline. The Visual Analogic Scale scores 4 hours after treatment were
 significantly different compared with those of the placebo group5. At present, the clinical
 application of theophylline has been replaced by aminophylline and doxofylline, and it is
 difficult to purchase theophylline in most hospitals in China and other countries.

 The Aminophylline for Patients With Post-Dural Puncture Headache trial, is a
 prospective,randomized,double-blind,placebo-controlled trial to evaluate the efficacy and
 safety of an IV injection of aminophylline on post-dural puncture headache.Eligible patients
 were randomized in a blinded fashion(1:1) to receive IV injection of aminophyllineor or
 sterile isotonic saline.The investigators estimate that this trial will demonstrate that an
 IV injection of aminophylline could be the preferred method for the clinical treatment of
 PDPH.
Inclusion Criteria:

 -  headache has developed after the dural puncture;

 -  PDPH was defined according to the International Classification of Headache Disorders
 III (ICHD-3) criteria;

 -  The VAS score of the headache was 5 or more than 5;

 -  age between 18 and 70 years old.

 Exclusion Criteria:

 -  a previous history of headache that could interfere with PDPH diagnosis;

 -  a history of central nervous system diseases including intracranial hemorrhage,
 seizures, intracranial hypertension, and hydrocephalus;

 -  a history of cardiovascular system diseases including coronary heart disease,
 arrhythmias, and hypertension;

 -  a history of peptic ulcer.

 -  women who were pregnant, nursing, or planning a pregnancy.