TITLE:
Synergistic Effect of a Selective Serotonin Reuptake Inhibitor and a Selective Cyclo-Oxygenase-2 Inhibitor on Post Spinal Anesthesia Headache
AUTHORS:
Rivain Fefe Iteke, David Mwembo Mutombo, Franck Namegabe Zirhumana, Olivier Kabiriko Mukuku, Emmanuel Kiyana Muyumba, Tinsley Mukakala Kibonge, Jean Francois Brichant, Adolphe Manzanza Kilembe, Yapo Brouh, Jean Baptiste Zambeze Sakatolo Kakoma
KEYWORDS:
Nefopam, Celecoxib, Headache, Rachianesthesia, Obstetrics
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.11 No.8,
August
31,
2020
ABSTRACT: Objective: To evaluate the synergistic effect of a Selective
Serotonin Reuptake Inhibitor (SSRI) and a Selective Cyclooxygenase 2 Inhibitor
(ISCOx-2) in the management of After Rachianesthesia Headache in Obstetric
Care. Patients and Methods: This was an experimental double-blind,
randomized, multi-center clinical trial of non-inferiority clinical trials over
a 12-month period (May 1, 2018 to April 30, 2019) in six hospitals in
southeastern DR Congo, including all patients undergoing surgery or
analgesia on spinal anesthesia for obstetrical indication and with headache
characteristic of a dural breccia, with no known causes, contraindications to
experimental products and informed consent to been obtained. The patients were
divided into four different groups depending on the protocol used, namely:
Group A = Rehydration + Paracetamol, Group B = Rehydration + Celecoxib, Group C
= Rehydration + Nefopam and Group 4 = Rehydration + Celecoxib + Nefopam (Study
Group). Using the Statview II software, the statistical analyzes of data
obtained from the different tests were made using the ANOVA test for comparing
the averages of different samples using the Fisher test. Verification of the
normality of the samples was made by the Kurtosis and Skewness flattening and
asymmetry test. Results: The protocol associating Celecoxib and Nefopam
significantly demonstrates its effectiveness in reducing CPRAOs in the first
two days with a gradual decrease in anxiety and length of stay. In addition,
the majority of patients (75.6%) had a high overall level of satisfaction with
this protocol. Conclusion: The Nefopam-Celecoxib combination shows its
effectiveness in the early reduction of these CPRAOs, anxiety and length of
stay with a high overall level of patient satisfaction. Given the good
tolerance and accessibility of these products, we strongly suggest the use of
this protocol for its validation in our environment and elsewhere, although it
is desirable to continue research on other non-explored alien pathways.