Going Through Surgery is Hard Enough Already
Don't Add Caffeine Withdrawal to the List of Problems
Many patients that have done well from the surgery suffer severe headaches
that may well be caused by caffeine withdrawal.
Stop caffeine consumption well before you have the operation.
Anesth Analg 1991 Apr;72(4):449-53
Is caffeine withdrawal the mechanism of postoperative headache?
Fennelly M, Galletly DC, Purdie GI
Department of Anaesthesia, Royal Postgraduate Medical School, Hammersmith
Hospital, London, England.
This study examined the hypothesis that headache after general anesthesia is
related to a caffeine withdrawal state. Two hundred eighty-seven patients
undergoing minor elective procedures under general anesthesia were studied. Four
to six hours after anesthesia each patient completed a questionnaire assessing
his or her own alcohol, tobacco, and caffeine consumption, and the occurrence of
postoperative side effects. A highly significant difference was found between
the caffeine consumption of patients with and without preoperative (P = 0.0035)
and postoperative (P less than 0.0001) headache. Logistic regression analysis of
trend between headache and caffeine consumption suggested that with each 100-mg
increase in caffeine consumption, there was a 12% increase in the odds of
headache developing in the immediate preoperative period (P less than 0.0066)
and a 16% increase in the odds of postoperative headache developing (P less than
0.0001). No relationship was found between headache and the patients' age, sex,
usual frequency of headache, consumption of alcohol or nicotine, or the
anesthetic agents or adjuvants used. It is concluded that postoperative headache
is related to caffeine intake and that this relationship is explained, at least
in part, by a perioperative caffeine withdrawal syndrome.
Mayo Clin Proc 1993 Sep;68(9):842-5
Perioperative ingestion of caffeine and postoperative headache.
Weber JG, Ereth MH, Danielson DR
Department of Anesthesiology, Mayo Clinic Rochester, Minnesota 55905.
The interruption of daily consumption of caffeine-containing beverages can
cause headache and other symptoms within 8 hours. Resumption of caffeine
alleviates these symptoms. Surgical patients routinely fast preoperatively and
may have postoperative symptoms from caffeine withdrawal. In the current study,
we determined whether perioperative caffeine consumption altered the incidence
of postoperative headache. After institutional approval of the study design, 233
surgical outpatients were surveyed about history of headaches, caffeine
consumption, and the presence and severity of headaches postoperatively. Of the
233 patients, 190 (82%) drank caffeinated beverages daily (mean daily
consumption, 290 mg of caffeine). Postoperative headaches occurred in 22% of
patients who routinely drank caffeinated beverages but in only 7% of those who
did not (P < 0.03). Other factors associated with postoperative headaches
included a history of frequent headaches (P < 0.0001), age of 50 years or
younger (P < 0.002), and amount of daily caffeine ingested (P < 0.01).
Among daily caffeine drinkers, those who drank caffeinated beverages on the day
of the surgical procedure had a lower incidence of postoperative headaches than
did those who abstained (17% versus 28%; P < 0.04). Postoperative headaches
may be related to several factors. Perioperative intake of caffeine altered
postoperative well-being. Caffeine given preoperatively may limit postoperative
withdrawal headaches among the millions of daily drinkers of caffeinated
beverages. A randomized, prospective, and blinded trial to test this hypothesis
is warranted.
