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For rapid treatment of obstetric patients with post-dural puncture headache, sphenopalatine ganglion block is effective and safe.
A prospective randomized clinical trial showed that transnasal sphenopalatine ganglion block (SPGB), a simple, safe, and noninvasive procedure with a low complication risk, can rapidly and effectively cure post-dural puncture headache (PDPH) in obstetric patients. Researchers aimed to explore the effectiveness of SPGB for PDPH management.
A total of 40 PDPH subjects were randomly segregated into two groups. For one day, the patients in the paracetamol group received 1 g of paracetamol intravenously three times a day. Rescue analgesia in the form of intravenous ketorolac was administered if sufficient pain relief was not achieved. The patients in block group received a 3 ml dose of a Dexamethasone and Lignocaine combination in each nostril during bilateral SPGB.
The heart rate, mean arterial pressure, and pain scores were noted. Additionally, hospital stay for epidural blood patch (EBP) or hospital discharge post 24 hours, patient satisfaction, total dose of Ketorolac, side effects, duration of analgesia, and onset of analgesia were also recorded. The pain perception (as estimated by numeric rating scale [NRS]) in the block group was typically lower throughout the research, with only a highly substantial difference until the first 2 hours following the block along with a longer duration and rapid onset of analgesia.
The block group exhibited a better level of patient satisfaction, lower total dosage of rescue analgesic in mg, and considerably reduced hospital stay for EBP. Thus, SPGB can be effectively used for rapid control of PDPH.
Ain-Shams Journal of Anesthesiology
Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial
Marwa M. Mowafi et al.
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