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Prophylactic Intravenous Administration of Caffeine and Recovery After Ambulatory Surgical Procedures


      To determine whether prophylactic intravenous administration of caffeine, to daily caffeine users, decreases the frequency of postoperative headache and shortens recovery time.


      The study was a prospective, randomized, double-blind investigation with predetermined sample size and statistical power.

      Material and Methods

      After Mayo Institutional Review Board approval and informed consent were obtained, 300 adult ambulatory surgical patients were enrolled in this study, which included randomization to receive either placebo or caffeine (200 mg intravenously) in the postanesthesia care unit. While recuperating, patients were allowed their choice of postoperative beverages. Before dismissal, patients completed a questionnaire providing details about intake of caffeine and tobacco, history of headache, and demographic data. Patients were considered “at risk” for symptoms of caffeine withdrawal if they did not drink a caffeinated beverage after the surgical procedure.


      Completed questionnaires were obtained from 234 patients. Patients at risk for symptoms of caffeine withdrawal were less likely to have a postoperative headache if they received caffeine intravenously rather than placebo—10% versus 23% (P <0.05). Time until recovery was not significantly different between caffeine and placebo study groups.


      We conclude that prophylactic intravenous administration of caffeine was beneficial for those patients at risk for symptoms of caffeine withdrawal. For patients who consume caffeinated beverages on a daily basis, we recommend prophylactic administration of caffeine on the day of an ambulatory surgical procedure and anesthesia.
      PACU (postanesthesia care unit)
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        • Gilbert RM
        • Marshman JA
        • Schwieder M
        • Berg R
        Caffeine content of beverages as consumed.
        Can Med Assoc J. 1976; 114: 205-208
        • Silverman K
        • Evans SM
        • Strain EC
        • Griffiths RR
        Withdrawal syndrome after the double-blind cessation of caffeine consumption.
        N Engl J Med. 1992; 327: 1109-1114
        • Shorofsky MA
        • Lamm RN
        Caffeine-withdrawal headache and fasting.
        NY State J Med. 1977; 77: 217-218
        • Hughes JR
        • Higgins ST
        • Bickel WK
        • Hunt WK
        • Fenwick JW
        • Gulliver SB
        Caffeine self-administration, withdrawal, and adverse effects among coffee drinkers.
        Arch Gen Psychiatry. 1991; 48: 611-617
        • Griffiths RR
        • Woodson PP
        Caffeine physical dependence: a review of human and laboratory animal studies.
        Psychophar-macology. 1988; 94: 437-451
        • Greden JF
        • Victor BS
        • Fontaine P
        • Lubetsky M
        Caffeine-withdrawal headache: a clinical profile.
        Psychosomatics. 1980; 21 (417-418): 411-413
        • Fennelly M
        • Galletly DC
        • Purdie GI
        Is caffeine withdrawal the mechanism of postoperative headache?.
        Anesth Analg. 1991; 72: 449-453
        • Nikolajsen L
        • Larsen KM
        • Kierkegaard O
        Effect of previous frequency of headache, duration of fasting and caffeine abstinence on perioperative headache.
        Br J Anaesth. 1994; 72: 295-297
        • Weber JG
        • Ereth MH
        • Danielson DR
        Perioperative ingestion of caffeine and postoperative headache.
        Mayo Clin Proc. 1993; 68: 842-845
        • Hampl KF
        • Schneider MC
        • Rüttimann U
        • Ummenhofer W
        • Drewe J
        Perioperative administration of caffeine tablets for prevention of postoperative headaches.
        Can J Anaesth. 1995; 42: 789-792
        • Weber JG
        • Ereth MH
        • Danielson DR
        • Ilstrup DM
        Prophylactic oral caffeine and postoperative headaches [abstract].
        Anesthesiology. 1993; 79: A25
        • Kuznicki JT
        • Turner LS
        The effects of caffeine on caffeine users and non-users.
        Physiol Behav. 1986; 37: 397-408
        • Griffiths RR
        • Evans SM
        • Heishman SJ
        • Preston KL
        • Sannerud CA
        • Wolf B
        Low-dose caffeine physical dependence in humans.
        J Pharmacol Exp Ther. 1990; 255: 1123-1132
        • Laska EM
        • Sunshine A
        • Mueller F
        • Elvers WB
        • Siegel C
        • Rubin A
        Caffeine as an analgesic adjuvant.
        JAMA. 1984; 251: 1711-1718
      1. Stoelting RK, “NPO” and aspiration pneumonitis—changing perspectives. In: 46th Annual Refresher Course Lectures and Clinical Update Program (presented during the Annual Meeting of the American Society of Anesthesiologists); 1995 Oct. 21– 25 423/1-432/7 Atlanta

        • Green CR
        • Pandit SK
        • Schork MA
        Preoperative fasting time: is the traditional policy changing? Results of a national survey.
        Anesth Analg. 1996; 83: 123-128
      2. US Bureau of the Census. Statistical Abstract of the United States, 1995: The National Data Book. 115th ed. Washington (DC): US Department of Commerce; 1995. p 130