Steroids Provide Temporary Improvement of Refractory Pain Following Subarachnoid Hemorrhage

• DOI: 10.1177/19418744231172350
• Publication Date: 2023-04-28T19:47:07Z
• Authors: Matthew N. Jaffa; Jamie E. Podell; Arshom Foroutan; Melissa Motta; Wan-Tsu W. Chang; Jacob Cherian; Melissa B. Pergakis; Gunjan Y. Parikh; J. Marc Simard; Michael J. Armahizer; Neeraj Badjatia; Nicholas A. Morris
• Keywords: Refractory (planetary science); Acetaminophen

Introduction Evidence for optimal analgesia following subarachnoid hemorrhage (SAH) is limited. Steroid therapy pain refractory to standard regimens common despite lack of evidence its efficacy. We sought determine if steroids reduced or utilization other analgesics when given headache SAH. Methods performed a retrospective within-subjects cohort study SAH patients who received headache. compared daily scores, total opioid, and acetaminophen doses before, during, after steroids. Repeated measures were analyzed with multivariable general linear model generalized estimating equations. Results Included 52 treated dexamethasone SAH, whom 11 second course, increasing 63 treatment epochs. Mean score on the first day was 7.92 (standard error mean [SEM] .37) decreased 6.68 (SEM .36) before quickly returning baseline levels, 7.36 .33), completion treatment. Total mirrored this trend. opioid days one two 47.83mg 6.22) 1848mg 170.66), 34.24mg 5.12) 1809mg 150.28), 46.38mg 11.64) 1833mg 174.23), respectively. Response associated older age, decreasing dosing, longer duration Hyperglycemia sleep disturbance/delirium effected 28.6% 55.6% cases, Conclusion in may have modest, transient effects select patients.