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

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.