Comparison of cosyntropin versus caffeine for post-dural puncture headaches: A randomized double-blind trial.

RESULTS: Thirty-seven patients were included and four patients were excluded from the analysis because of protocol violations or incomplete data. Analysis was based on intention-to-treat. Caffeine was 80% (95% CI 60–100%) effective and cosyntropin was 56% (95% CI 33–79%) effective in treating post-dural puncture headaches. The group's VAS scores at 0, 60, and 120 minutes were 80 mm, 41 mm, 31 mm for caffeine and 80 mm, 40 mm, 33 mm for cosyntropin, respectively ( P=0.66). CONCLUSION: Caffeine was not more effective than cosyntropin in treating patients with postdural puncture headaches, and there was no difference in the degree of pain relief on VAS assessment.