PERIOPERATIVE ADMINISTRATION OF CAFFEINE TABLETS FOR PREVENTION OF POSTOPERATIVE HEADACHES

Interruption of daily caffeine consumption can cause caffeine withdraw al headache. As headache ranks among the most frequent minor postopera tive sequelae, the impact of perioperative substitution of caffeine on the incidence of postoperative headache was evaluated. Forty patients undergoing minor surgical procedures with general anaesthesia were ra ndomly allocated to receive either placebo or caffeine tablets at a do sage equal to their individual average daily caffeine consumption. Dai ly dietary intake was calculated based on an average weekday consumpti on using conversion factors from previously published sources. The pat ients were instructed at the preoperative visit to abstain from all ex ternal sources of caffeine. Compliance with these dietary restrictions was verified by blood samples obtained immediately before the surgica l procedure and on postoperative day 1. The patients were assessed for headache using a standardised checklist immediately before induction of anaesthesia, on the evening of the day of surgery and on the mornin g of postoperative day 1. Ten patients (50%) who received placebo repo rted headaches which persisted in seven patients (35%) until the next day. No patient receiving caffeine substitution therapy reported heada che following surgery, and only one complained of headache on postoper ative day 1. We suggest that the prophylactic administration of caffei ne tablets might be considered for surgical patients who are accustome d to a high daily intake of caffeine.