Sumatriptan in patients with postdural puncture headache

Objective.-To determine the efficacy of sumatriptan in the management of patients presenting for an epidural blood patch for the management of postdural puncture headache, Background.-Postdural puncture headache can be quite severe, requiring invasive therapy (ie, epidural blood patch). Sumatriptan has been used successfully in patients with postdural puncture headache, however, its use has not been investigated in a controlled fashion. Methods.-Ten patients with postdural puncture headache presenting for an epidural blood patch were given either saline or sumatriptan subcutaneously. The severity of the headache was evaluated at baseline and 1 hour following injection. If the headache remained severe, an epidural blood patch was performed. Results.-Only one patient in each group received relief front the injection. Conclusions.-We do not recommend sumatriptan in patients who have exhausted conservative management of postdural puncture headache.