Intervention Review

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Drug therapy for preventing post-dural puncture headache

  1. Xavier Basurto Ona1,*,
  2. Sonia Maria Uriona Tuma2,
  3. Laura Martínez García3,
  4. Ivan Solà4,
  5. Xavier Bonfill Cosp5

Editorial Group: Cochrane Pain, Palliative and Supportive Care Group

Published Online: 28 FEB 2013

DOI: 10.1002/14651858.CD001792.pub3

How to Cite

Basurto Ona X, Uriona Tuma SM, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for preventing post-dural puncture headache. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD001792. DOI: 10.1002/14651858.CD001792.pub3.

Author Information

  1. 1

    Hospital de Figueres, Fundació Salut Empordà, Emergency Department, Figueres, Girona-Catalunya, Spain

  2. 2

    Vall Hebron University Hospital, Preventive Medicine and Public Health, Barcelona, Catalunya, Spain

  3. 3

    Biomedical Research Institute Sant Pau (IIB Sant Pau), Iberoamerican Cochrane Centre, Barcelona, Catalunya, Spain

  4. 4

    CIBER Epidemiología y Salud Pública (CIBERESP) - Universitat Autònoma de Barcelona, Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Catalunya, Spain

  5. 5

    CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Catalunya, Spain

*Xavier Basurto Ona, Emergency Department, Hospital de Figueres, Fundació Salut Empordà, Rda Rector Aroles s/n, Figueres, Girona-Catalunya, 17600, Spain.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 28 FEB 2013



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Abboud 1992 {published data only}
Al-metwalli 2008 {published data only}
Devcic 1993 {published data only}
  • Devcic A, Sprung J, Patel S, Kettler R, Maitra-D'Cruze A. PDPH in obstetric anesthesia: comparison of 24-gauge Sprotte and 25-gauge Quincke needles and effect of subarachnoid administration of fentanyl. Regional Anesthesia 1993;18(4):222-5.
Doroudian 2011 {published data only}
  • Doroudian MR, Norouzi M, Esmailie M, Tanhaeivash R. Dexamethasone in preventing post-dural puncture headache: a randomized, double-blind, placebo-controlled trial. Acta Neurologica Belgica 2011;62:143-6.
Esmaoglu 2005 {published data only}
  • Esmaoglu A, Akpinar H, Uğur F. Oral multidose caffeine-paracetamol combination is not effective for the prophylaxis of postdural puncture headache. Journal of Clinical Anesthesia 2005;17(1):58-61.
Flaatten 1987 {published data only}
Hakim 2010 {published data only}
Sadeghi 2012 {published data only}
  • Sadeghi SE, Abdollahifard G, Nasabi NA, Mehrabi M, Safarpour AR. Effectiveness of single dose intravenous aminophylline administration on prevention of post dural puncture headache in patients who received spinal anesthesia for elective cesarean section. World Journal of Medical Sciences 2012;7(1):13-6.
Strelec 1994 {published data only}
  • Strelec S, Prylinski J, Sakert T, Royal M. The efficacy of multi-dose oral caffeine in prevention of post-dural puncture headache. Regional Anesthesia 1994;19(2S):79.
Yousefshahi 2012 {published data only}
  • Yousefshahi F, Dahmardeh AR, Khajavi M, Najafi A, Khashayar P, Barkhordari K. Effect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial. Acta Neurologica Belgica 2012 Apr 20 [Epub ahead of print].

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Ackerman 2004 {published data only}
  • Ackerman WE, Juneja MM, Kaczorowski DM. Prophylactic epidural blood patch for the prevention of postdural puncture headache in the parturient. Anesthesiology Review 1990;17(2):45-9.
Altunkaya 2005 {published data only}
  • Altunkaya H, Ozer Y, Demirel CB, Ozkocak I, Keser S, Bayar A. Preoperative multimodal administration of morphine in arthroscopic surgery. Archives of Orthopaedic and Trauma Surgery 2005;125(9):609-13.
Aziz 1968 {published data only}
Balestrieri 2003 {published data only}
Beilin 2003 {published data only}
Breebaart 2003 {published data only}
  • Breebaart MB, Vercauteren MP, Hoffmann VL, Adriaensen HA. Urinary bladder scanning after day-case arthroscopy under spinal anaesthesia: comparison between lidocaine, ropivacaine, and levobupivacaine. British Journal of Anaesthesia 2003;3:309-13.
Caldwell 1994 {published data only}
  • Caldwell LE, Rosen MA, Shnider SM. Subarachnoid morphine and fentanyl for labor analgesia. Efficacy and adverse effects. Regional Anesthesia 1994;19(1):2-8.
Camann 1992 {published data only}
Camann 1993 {published data only}
Campbell 1995 {published data only}
  • Campbell DC, Camann WR, Datta S. The addition of bupivacaine to intrathecal sufentanil for labor analgesia. Anesthesia and Analgesia 1995;81(2):305-9.
Cesur 2009 {published data only}
  • Cesur M, Alici HA, Erdem AF, Silbir F, Celik M. Decreased incidence of headache after unintentional dural puncture in patients with cesarean delivery administered with postoperative epidural analgesia. Journal of Anesthesia 2009;23(1):31-5.
Chalmers 1988 {published data only}
  • Chalmers PC, Lang CM, Harte FA, Greenhouse BB. Double-blind comparison of intravenous nalbuphine and placebo in the amelioration of side-effects of epidural narcotics. Pain Clinic 1988;2(1):49-56.
Chilvers 1997 {published data only}
  • Chilvers CR, Vaghadia H, Mitchell GW, Merrick PM. Small-dose hypobaric lidocaine-fentanyl spinal anesthesia for short duration outpatient laparoscopy. II. Optimal fentanyl dose. Anesthesia and Analgesia 1997;84(1):65-70.
Cho 2008 {published data only}
Clarke 2009 {published data only}
  • Clarke H, Pereira S, Kennedy D, Gilron I, Katz J, Gollish J, et al. Gabapentin decreases morphine consumption and improves functional recovery following total knee arthroplasty. Pain Research and Management 2009;14(3):217-22.
Colonna-Romano 1989 {published data only}
  • Colonna-Romano P, Shapiro BE. Unintentional dural puncture and prophylactic epidural blood patch in obstetrics. Anesthesia and Analgesia 1989;69:522-3.
Cowan 1980 {published data only}
D'Angelo 1994 {published data only}
Danelli 2004 {published data only}
  • Danelli G, Fanelli G, Berti M, Cornini A, Lacava L, Nuzzi M, et al. Spinal ropivacaine or bupivacaine for cesarean delivery: a prospective, randomized, double-blind comparison. Regional Anesthesia and Pain Medicine 2004;29(3):221-6.
Dayioglu 2009 {published data only}
  • Dayioglu H, Baykara ZN, Salbes A, Solak M, Toker K. Effects of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in knee arthroscopy. Journal of Anesthesia 2009;23(1):19-25.
Delfino 2001 {published data only}
  • Delfino J, Do Vale NB. Spinal anesthesia with 0.5% isobaric ropivacaine or levobupivacaine for lower limb surgeries. Revista Brasileira de Anestesiologia 2001;51(2):91-7.
De Pietri 2006 {published data only}
  • De Pietri L, Siniscalchi A, Reggiani A, Masetti M, Begliomini B, Gazzi M, et al. The use of intrathecal morphine for postoperative pain relief after liver resection: a comparison with epidural analgesia. Anesthesia and Analgesia 2006;102(4):1157-63.
Dijkstra 2008 {published data only}
  • Dijkstra T, Reesink JA, Verdouw BC, Van der Pol WS, Feberwee T, Vulto AG. Spinal anaesthesia with articaine 5% vs bupivacaine 0.5% for day-case lower limb surgery: a double-blind randomized clinical trial. British Journal of Anaesthesia 2008;100(1):104-8.
Dilli 2008 {published data only}
  • Dilli D, Dallar Y, Sorgui NH. Intravenous ketamine plus midazolam vs. intravenous ketamine for sedation in lumbar puncture: a randomized controlled trial. Indian Pediatrics 2008;45(11):899-904.
Dominguez-Hervella 1993 {published data only}
  • Domínguez-Hervella FD, Rey MS, Guede GR, Martín V, Martínez J, Castro A. Combined subarachnoid and epidural block with a single injection, with a modified Tuohy needle and used in hip surgery. Revista Española de Anestesiología y Reanimación 1993;40(5):279-83.
Edström 1986 {published data only}
  • Edström HH, Blitt CD, Draper EM, Manny BT, Hameroff SR. Hypotension in spinal anesthesia: a comparison of tetracaine and bupivacaine. Regional Anesthesia and Pain Medicine 1986;11:139-42.
Elkhodair 2010 {published data only}
  • Elkhodair S. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Bet 1. Caffeine in the prophylaxis of postlumbar puncture headache. Emergency Medicine Journal 2010;27(6):476-7.
Fogarty 1993 {published data only}
  • Fogarty DJ, Carabine UA, Milligan KR. Comparison of the analgesic effects of intrathecal clonidine and intrathecal morphine after spinal anaesthesia in patients undergoing total hip replacement. British Journal of Anaesthesia 1993;71(5):661-4.
Fogarty 1995 {published data only}
Förster 2006 {published data only}
  • Förster JG, Rosenberg PH, Niemi TT. Continuous spinal microcatheter (28 gauge) technique for arterial bypass surgery of the lower extremities and comparison of ropivacaine with or without morphine for postoperative analgesia. British Journal of Anaesthesia 1996;97(3):393–400.
Frey 1998 {published data only}
  • Frey K, Holman S, Mikat-Stevens M, Vazquez J, White L, Pedicini E, et al. The recovery profile of hyperbaric spinal anesthesia with lidocaine, tetracaine, and bupivacaine. Regional Anesthesia and Pain Medicine 1998;23(2):159-63.
Frizelle 1997 {published data only}
Fu 2008 {published data only}
Fujii 1998 {published data only}
Gangopadhyay 2010 {published data only}
  • Gangopadhyay S, Gupta K, Acharjee S, Nayak SK, Dawn S, Piplai G. Ketamine, tramadol and pethidine in prophylaxis of shivering during spinal anaesthesia. Journal of Anaesthesiology Clinical Pharmacology 2010;26(1):59-63.
Ganzi 1995 {published data only}
  • Ganzi F, Ganzi L, Sabo D, Mandell G, Ramanathan S, Patel R. Incidence of spinal headache after spinal anesthesia: a prospective randomized study. Anesthesia and Analgesia 1995;80:S143.
Garg 2010 {published data only}
  • Garg A, Ahmed F, Khandelwal M, Chawla V, Verma AP. The effect of transdermal nitroglycerine on intrathecal fentanyl with bupivacaine for postoperative analgesia following gynaecological surgery. Anaesthesia and Intensive Care 2010;38(2):285-90.
Gielen 1986 {published data only}
  • Gielen M, Huho J, DeGrood PM, Edström HH. A double-blind evaluation of hyperbaric solutions of bupivacaine 0.5% and lidocaine 5% in spinal anesthesia. Regional Anesthesia 1986;11:176-81.
Ginsberg 1996 {published data only}
Girgin 2008 {published data only}
  • Girgin NK, Gurbet A, Turker G, Bulut T, Demir S, Kilic N, et al. The combination of low-dose levobupivacaine and fentanyl for spinal anaesthesia in ambulatory inguinal herniorrhaphy. Journal of International Medical Research 2008;36(6):1287-92.
Gogarten 2004 {published data only}
  • Gogarten W, Van de Velde M, Soetens F, Van Aken H, Brodner G, Gramke HF, et al. A multicentre trial comparing different concentrations of ropivacaine plus sufentanil with bupivacaine plus sufentanil for patient-controlled epidural analgesia in labour. European Journal of Anaesthesiology 2004;21(1):38-45.
Gurbet 2008 {published data only}
  • Gurbet A, Turker G, Girgin NK, Aksu H, Bahtiyar NH. Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery. Journal of International Medical Research 2008;365:964-70.
Hansen 1979 {published data only}
Hansen 1980 {published data only}
Harsten 1997 {published data only}
Hein 2010 {published data only}
  • Hein A, Rosblad P, Norman M, Ryniak S, Tingaker B, Jakobsson J, et al. Addition of low-dose morphine to intrathecal bupivacaine/sufentanil labour analgesia: a randomised controlled study. International Journal of Obstetric Anesthesia 2010;19(4):384-9.
Hendriks 2009 {published data only}
  • Hendriks MP, De Weert CJM, Snoeck MMJ, Hu HP, Pluim MAL, Gielen MJM. Plain articaine or prilocaine for spinal anaesthesia in day-case knee arthroscopy: a double-blind randomized trial. British Journal of Anaesthesia 2009;102(2):259-63.
Ilioff 1990 {published data only}
  • Ilioff G, Strelec SR, Rothfus W, Teeple E. Does prophylactic intramuscular caffeine sodium benzoate decrease incidence of post dural puncture headache. Regional Anesthesia 1990;15(1S):65.
Imbelloni 2003 {published data only}
  • Imbelloni LE, Vieira EM, Rocha A, Gouveia MA, Cordeiro JA. Spinal anesthesia for cesarean section with 0.5% isobaric bupivacaine plus fentanyl and morphine. Prospective study with different volumes. Revista Brasileira de Anestesiologia 2003;53(3):322-30.
Imbelloni 2009 {published data only}
  • Imbelloni LE,  Gouveia MA,  Vieira EM, Cordeiro JA. A randomised, double-blind comparison of three different volumes of hypobaric intrathecal bupivacaine for orthopaedic surgery. Anaesthesia and Intensive Care 2009;37(2):242-7.
Imbelloni 2010 {published data only}
  • Imbelloni LE, Gouveia MA, Cordeiro JA. Hypobaric 0.15% bupivacaine versus hypobaric 0.6% lidocaine for posterior spinal anesthesia in outpatient anorectal surgery. Revista Brasileira de Anestesiologia 2010;60(2):113-20.
Jacobsohn 2005 {published data only}
  • Jacobsohn E, Lee TWR, Amadeo RJ, Syslak PH, Debrouwere RG, Bell D, et al. Low-dose intrathecal morphine does not delay early extubation after cardiac surgery. Canadian Journal of Anesthesia 2005;52(8):848-57.
Kallio 2004 {published data only}
  • Kallio H, Snall EVT, Kero MP, Rosenberg PH. A comparison of intrathecal plain solutions containing ropivacaine 20 or 15 mg versus bupivacaine 10 mg. Anesthesia and Analgesia 2004;99(3):713-7.
Kallio 2005 {published data only}
Kaukinen 1981 {published data only}
  • Kaukinen S, Kaukinen L, Kannisto K, Kataja M. The prevention of headache following spinal anaesthesia. Annales Chirurgiae et Gynaecologiae 1981;70(3):107-11.
Kouri 2004 {published data only}
Lanz 1982 {published data only}
Lauretti 1999 {published data only}
  • Lauretti GR, de Oliveira R, Reis MP, Mattos AL, Pereira NL. Transdermal nitroglycerine enhances spinal sufentanil postoperative analgesia following orthopedic surgery. Anesthesiology 1999;90(3):734-9.
Lauretti 1999b {published data only}
  • Lauretti GR, de Oliveira R, Julião MCC, Reis MP, Paccola CAJ. Postoperative analgesia by intra-articular and epidural neostigmine following knee surgery. Regional Anesthesia and Pain Medicine 1999;24(3):17.
Lauretti 2000 {published data only}
  • Lauretti GR, de Oliveira R, Perez MV, Paccola CAJ. Postoperative analgesia by intraarticular and epidural neostigmine following knee surgery. Journal of Clinical Anesthesia 2000;12(6):444-8.
Lauretti 2000b {published data only}
  • Lauretti GR, Oliveira AP, Julião MC, Reis MP, Pereira NL. Transdermal nitroglycerine enhances spinal neostigmine postoperative analgesia following gynecological surgery. Anesthesiology 2000;93(4):943-6.
Lee 2005 {published data only}
Lewis 1992 {published data only}
  • Lewis RP, Spiers SP, McLaren IM, Hunt PC, Smith HS. Pethidine as a spinal anaesthetic agent - a comparison with plain bupivacaine in patients undergoing transurethral resection of the prostate. European Journal of Anaesthesiology 1992;9(2):105-9.
Lierz 2004 {published data only}
  • Lierz P, Gustorff B, Markow G, Felleiter P. Comparison between bupivacaine 0.125% and ropivacaine 0.2% for epidural administration to outpatients with chronic low back pain. European Journal of Anaesthesiology 2004;21:32-7.
López-Soriano 2002 {published data only}
  • López-Soriano F, Lajarín B, Rivas F, Verdú JM, López-Robles J. Hyperbaric subarachnoid ropivacaine in ambulatory surgery: comparative study with hyperbaric bupivacaine. Revista Española de Anestesiología y Reanimación 2002;49:71-5.
Luck 2008 {published data only}
  • Luck JF, Fettes PDW, Wildsmith JAW. Spinal anaesthesia for elective surgery: a comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine. British Journal of Anaesthesia 2008;101(5):705-10.
Manaa 2005 {published data only}
  • Manaa EM, El-Faroug O. Comparative study between intrathecal low-dose bupivacaine versus lidocaine for anorectal surgery. Egyptian Journal of Anaesthesia 2005;21:75-8.
Martlew 2009 {published data only}
Massou 2008 {published data only}
  • Massou S,  Drissi M,  Hatim G,  Ibat D,  Drissi Kamili N,  Atmani M. Does propofol have effect on postdural puncture headache?. Annales Francaises d Anesthesie et de Reanimation 2008;27(10):861-2.
Meininger 2003 {published data only}
  • Meininger D, Byhahn C, Kessler P, Nordmeyer J, Alparslan Y, Hall BA, et al. Intrathecal fentanyl, sufentanil, or placebo combined with hyperbaric mepivacaine 2% for parturients undergoing elective cesarean delivery. Anesthesia and Analgesia 2003;96:852–8.
Michalek-Sauberer 2008 {published data only}
  • Michalek-Sauberer A, Kozek-Langenecker SA, Heinzl H, Deusch E, Chiari A. Median effective local anesthetic doses of plain bupivacaine and ropivacaine for spinal anesthesia administered via a spinal catheter for brachytherapy of the lower abdomen. Regional Anesthesia and Pain Medicine 2008;33(1):4-9.
Morrison 1994 {published data only}
  • Morrison LM, Emanuelsson BM, McClure JH, Pollok AJ, McKeown DW, Brockway M, et al. Efficacy and kinetics of extradural ropivacaine: comparison with bupivacaine. British Journal of Anaesthesia 1994;72(2):164-9.
Mosavy 1975 {published data only}
Murto 1999 {published data only}
Møller 1984 {published data only}
Neilson 2008 {published data only}
  • Neilson G, Lennox P, Vaghadia H. Selective spinal anesthesia: a comparison of 2-chloroprocaine with lidocaine for ambulatory TUPR surgery. Canadian Journal of Anaesthesia 2008;55(S1):4752021-2.
Ogun 2003 {published data only}
  • Ogun CO, Kirgiz EN, Duman A, Okesli S, Akyurek C. Comparison of intrathecal isobaric bupivacaine-morphine and ropivacaine-morphine for Caesarean delivery. British Journal of Anaesthesia 2003;90(5):659-64.
Paech 1993 {published data only}
Palahniuk 1979 {published data only}
Pan 2001 {published data only}
  • Pan PH, Moore CH. Comparing the efficacy of prophylactic metoclopramide, ondansetron, and placebo in cesarean section patients given epidural anesthesia. Journal of Clinical Anesthesia 2001;13(6):430-5.
Patra 2005 {published data only}
  • Patra P, Kapoor MC, Nair TGM. Spinal anaesthesia with low dose bupivacaine and fentanyl for endoscopic urological surgeries. Journal of Anaesthesiology Clinical Pharmacology 2005;21(2):147-54.
Phero 1987 {published data only}
  • Phero JC, Bridenbaugh PO, Edström HH, Hagenouw RR, Knarr D, Mukkada TA, et al. Hypotension in spinal anesthesia: a comparison of isobaric tetracaine with epinephrine and isobaric bupivacaine without epinephrine. Anesthesia and Analgesia 1987;66(6):549-52.
Plaja 2000 {published data only}
  • Plaja I, Arxer A, Metje M, Santiveri X, Villalonga A, Fernandez MA, et al. Comparison of 5% prilocaine and 2% mepivacaine in spinal anesthesia for transurethral resection. Revista Espanola de Anestesiologia y Reanimacion 2000;47(5):194-7.
Prusinski 1974 {published data only}
  • Prusinski A, Klimek A. Sandomigran in the prevention of headaches following lumbar puncture. Neurologia i Neurochirurgia Polska 1974;8(4):565-8.
Radpay 2003 {published data only}
  • Radpay B, Karimi-Zandi S, Dabir S, Parsa T. Comparison between epidural morphine versus morphine + fentanyl in lung resection surgery. Archives of Iranian Medicine 2003;6(2):81-5.
Reinhart 1985 {published data only}
  • Reinhart K, Dallinger-Stiller G, Dennhardt R, Heinemeyer G, Eyrich K. Comparison of midazolam, diazepam and placebo i.m. as premedication for regional anaesthesia. A randomized double-blind study. British Journal of Anaesthesiology 1985;57(3):294-9.
Rivera-Ordonez 2005 {published data only}
  • Rivera-Ordonez A, Rivera-Flores J. Postoperative epidural analgesia: ketamine plus bupivacaine vs bupivacaine alone in hip and femur surgery. Revista Mexicana de Anestesiologia 2005;28(1):14-9.
Roux 1983 {published data only}
  • Roux FX, Mallet A, Meresse S. Prevention of cephalalgia following rachiocentesis. A controlled double blind trial of intravenous tiapride. Semaine des Hopitaux 1983;59(5):319-21.
Rucci 1985 {published data only}
Ryan 1983 {published data only}
  • Ryan DW, Pridie AK, Copeland PF. Plain bupivacaine 0.5%: a preliminary evaluation as a spinal anaesthetic agent. Annals of the Royal College of Surgeons of England 1983;65(1):40-3.
Sakaguchi 2000 {published data only}
  • Sakaguchi Y, Sakura S, Shinzawa M, Saito Y. Does adrenaline improve epidural bupivacaine and fentanyl analgesia after abdominal surgery?. Anaesthesia and Intensive Care 2000;28(5):522-6.
Sangarlangkarn 1987 {published data only}
Sanli 2005 {published data only}
  • Sanli S, Yegin A, Kayacan N, Yilmaz M, Coskunfirat N, Karsli B. Effects of hyperbaric spinal ropivacaine for caesarean section: with or without fentanyl. European Journal of Anaesthesiology 2005;22(6):457-61.
Santos 1986 {published data only}
  • Santos DJ, Barett T, Lachica R, Coyle D. Efficacy of epidural saline patch in preventing post-dural puncture headache. Regional Anesthesia 1986;11(1):42-3.
Sawhney 2004 {published data only}
  • Sawhney S, Gupta RC, Shukla RN, Chakravorty S, Kulkarni SN. Post-operative analgesia with epidural ketamine and morphine. Journal of Anaesthesiology Clinical Pharmacology 2004;20(4):401-5.
Sengupta 1989 {published data only}
Seyhan 2005 {published data only}
  • Seyhan TO, Baskan I, Karadeniz M, Senturk M. Epidural saline infusion for prophylaxis of postdural puncture headache a preliminary report. Regional Anesthesia and Pain Medicine 2005;30(5S1):75.
Shah 2003 {published data only}
  • Shah FR, Halbe AR, Panchal ID, Goodchild CS. Improvement in postoperative pain relief by the addition of midazolam to an intrathecal injection of buprenorphine and bupivacaine. European Journal of Anaesthesiology 2003;20(11):904-10.
Singh 2006 {published data only}
  • Singh V, Gupta LK, Singh GP. Comparison among intrathecal fentanyl and butorphanol in combination with bupivacaine for lower limb surgeries. Journal of Anaesthesiology Clinical Pharmacology 2006;22(4):371-5.
Smith 2004 {published data only}
Soni 2001 {published data only}
  • Soni AK, Miller CG, Pratt SD, Hess PE, Oriol NE, Sarna MC. Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. Canadian Journal of Anaesthesia 2001;48(7):677-80.
Sudarshan 1995 {published data only}
Tekin 2007 {published data only}
  • Tekin M, Kati I, Tomak Y, Kisli E. Effect of dexmedetomidine IV on the duration of spinal anesthesia with prilocaine: a double-blind, prospective study in adult surgical patients. Current Therapeutic Research - Clinical and Experimental 2007;68(5):313-24.
Thomas 2006 {published data only}
Trivedi 1993 {published data only}
Tsen 2001 {published data only}
  • Tsen LC, Schultz R, Martin R, Datta S, Bader AM. Intrathecal low-dose bupivacaine versus lidocaine for in vitro fertilization procedures. Regional Anesthesia and Pain Medicine 2001;26(1):52-6.
Tucker 2004 {published data only}
Tuncer 2005 {published data only}
  • Tuncer S, Bariskaner H, Reisli R, Sarkilar G, Cicekci F, Otelcioglu S. Effect of gabapentin on postoperative pain: a randomized, placebo-controlled clinical study. The Pain Clinic 2005;17(1):95-9.
Turan 2006 {published data only}
Turker 2003 {published data only}
Unlugenc 2006 {published data only}
  • Unlugenc H, Ozalevli M, Gunes Y, Olguner S, Evruke C, Ozcengiz D, et al. A double-blind comparison of intrathecal S(+) ketamine and fentanyl combined with bupivacaine 0.5% for Caesarean delivery. European Journal of Anaesthesiology 2006;23(12):1018-24.
Unlugenc 2009 {published data only}
Usubiaga 1967 {published data only}
  • Usubiaga JE,  Usubiaga LE,  Brea LM,  Goyena R. Effect of saline injections on epidural and subarachnoid space pressures and relation to postspinal anesthesia headache. Anesthesia and Analgesia 1967;46(3):293-6.
Vaghadia 1997 {published data only}
  • Vaghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small-dose hypobaric lidocaine-fentanyl spinal anesthesia for short duration outpatient laparoscopy. I. A randomized comparison with conventional dose hyperbaric lidocaine. Anesthesia and Analgesia 1997;84(1):59-64.
Vale 1995 {published data only}
  • Vale NB, Silva Neto JD, Magalhães Filho EB, Nascimento W, Pereira F, França A. Spinal anesthesia with 0.5% bupivacaine and 2% lidocaine without glucose in a fixed dose - efficacy/toxicity in the morning and in the afternoon. Revista Brasileira De Anestesiologia 1995;45(5):301-7.
Vichitvejpaisal 1992 {published data only}
  • Vichitvejpaisal P, Svastdi-Xuto O, Udompunturux S. A comparative study of isobaric and hyperbaric solution of bupivacaine for spinal anaesthesia in caesarean section. Journal of the Medical Association of Thailand 1992;75(5):278-82.
Viscusi 2005 {published data only}
  • Viscusi ER, Martin G, Hartrick CT, Singla N, Manvelian G. Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology 2005;102(5):1014-22.
Waxler 2004 {published data only}
  • Waxler B, Mondragon SA, Patel SN, Nedumgottil K. Intrathecal lidocaine and sufentanil shorten post-operative recovery after outpatient rectal surgery. Canadian Journal of Anesthesia 2004;51(7):680-4.
Wells 2004 {published data only}
Whiteside 2003 {published data only}
  • Whiteside JB, Burke D, Wildsmith JAW. Comparison of ropivacaine 0.5% (in glucose 5%) with bupivacaine 0.5% (in glucose 8%) for spinal anaesthesia for elective surgery. British Journal of Anaesthesia 2003;90(3):304-8.
Widerlöv 1979 {published data only}
Wilder-Smith 1998 {published data only}
Wood 1993 {published data only}
Yanagidate 2004 {published data only}
Yeh 2000 {published data only}
  • Yeh HM, Chen LK, Lin CJ, Chan WH, Chen YP, Lin CS, et al. Prophylactic intravenous ondansetron reduces the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery. Anesthesia and Analgesia 2000;91(1):172-5.
Yücel 1999 {published data only}
  • Yücel A, Ozyalçin S, Talu GK, Yücel EC, Erdine S. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Regional Anesthesia and Pain Medicine 1999;24(1):51-4.
Zackova 2000 {published data only}
  • Zackova M, Manfredini P, Strali W, Baravelli A, Furnari G, Accorsi A. Comparison of 0.125% bupivacaine and 0.2% ropivacaine in obstetric analgesia. Minerva Anestesiologica 2000;66(9):643-8.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
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