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Neostigmine and Glycopyrrolate for the Treatment of Headache After Dural Puncture

Neostigmine and Glycopyrrolate for the Treatment of Post Dural Puncture Headache After Known Dural Puncture With a Tuohy Needle: A Pilot Study

Who can join

Ages 18 to 54 · Women

Inclusion Criteria:

* Post-dural puncture headache (PDPH) after documented dural puncture with Tuohy needle during placement of epidural analgesia for labor and no other explanation for headache (HA).
* Onset of HA within 72 hours of delivery.

Exclusion Criteria:

* Patient refusal.
* Visual analog scale (NRS) score \< 4.
* History of migraine headaches.
* Asthma.
* Arrhythmia.
* Heart block.
* Myasthenia gravis.
* Inability to understand pain scores and other questionnaires.
* Inability to speak English.
* Contraindication to acetaminophen or NSAIDs.
* Temperature \> 38.5 C.
* Prior EBP done for this HA.

About the study

The purpose of this study is to evaluate Neostigmine and Glycopyrrolate to treat post-dural puncture headache (PDPH) to reduce the proportion of postpartum women with a PDPH requiring epidural blood patch (EBP) who developed a PDPH after accidental dural puncture.

What is being tested

• Neostigmine (drug)
• Glycopyrrolate (drug)

Sponsor: Mayo Clinic · Participants: 18 · Started: Nov 19, 2021

Contact the study team

Official record on ClinicalTrials.gov — NCT05116930

Locations in the U.S.

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.