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January 1, 1944


JAMA. 1944;124(1):56-57. doi:10.1001/jama.1944.02850010058023

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To the Editor:—  The editorial in The Journal, Oct. 9, 1943 entitled "Reactions After Spinal Puncture" interests me because of such reactions in connection with spinal anesthesia. These reactions, while rare of late years, after some considerable experience with spinal anesthesia are attributed by me primarily to an atraumatic puncture with a 20 gage spinal needle. The possible theories of the mechanism of these headaches is interesting but still largely academic.Of only empirical value in their treatment but nonetheless immediate in alleviation of these headaches is the slow intravenous injection of 7 1/2 grains (0.5 Gm.) of caffeine with sodium benzoate. One such injection results in complete cessation; rarely a second or third injection may be necessary at six hour intervals. There have never been any untoward reactions from this therapy in quite a number so treated for the past fifteen years.This observation was reported by me some

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