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. 2018 Dec;62(12):972-977.
doi: 10.4103/ija.IJA_443_18.

Sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric patients: An observational study

Nitu Puthenveettil  1 , Sunil Rajan  1 , Anish Mohan  1 , Jerry Paul  1 , Lakshmi Kumar  1
Affiliations

Sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric patients: An observational study

Nitu Puthenveettil et al. Indian J Anaesth. 2018 Dec.

Abstract

Background and aims: Post-dural puncture headache (PDPH) is a consequence of spinal and epidural anaesthesia in approximately 1% of obstetric patients. The gold standard for its treatment is epidural blood patch. Sphenopalatine ganglion block (SPGB) has been proposed as a non-invasive intervention with minimal adverse effect. The primary objective of this study was to assess the efficacy of SPGB for treatment of PDPH. Secondary objectives were to assess onset of analgesia, duration of block and adverse effects.

Methods: Twenty parturients diagnosed to have PDPH, resistant to standard treatment modalities such as intravenous fluids, abdominal binder, bed rest and caffeine, were recruited into this prospective observational study. Patients were allocated to either of the two groups. Group A patients received paracetamol 1 g 8 hourly intravenously for a day. If adequate pain relief was not achieved, diclofenac 75 mg 12 hourly was added. Patients in group B received SPGB with 2% lignocaine. Fisher's exact test, Mann-Whitney test and independent sample t-test were used for statistical analysis.

Results: About 88.89% patients in group B had adequate pain relief within 5 min of block (P < 0.001). Pain was significantly lower in Group B for up to 8 h, with no adverse effects.

Conclusion: SPGB is an effective initial modality for managing severe headache in patients with PDPH.

Keywords: Analgesia; obstetric; post-dural puncture headache; sphenopalatine ganglion block; spinal.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart
Figure 2
Figure 2
Diagrammatic representation of sphenopalatine ganglion block
Figure 3
Figure 3
Patient receiving sphenopalatine ganglion block
Figure 4
Figure 4
Mean pain score
Figure 5
Figure 5
Changes in heart rate
See this image and copyright information in PMC

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References

    1. Nair AS, Rayani BK. Sphenopalatine ganglion block for relieving postdural puncture headache: Technique and mechanism of action of block with a narrative review of efficacy. Korean J Pain. 2017;30:93–7. - PMC - PubMed
    1. Atim A, Ergin A, Yanarates O, Kuyumcu M, Kurt E. Epidural blood patch for the management of post-dural puncture headache. J Nervous Sys Surgery. 2009;2:67–71.
    1. Oedit R, van Kooten F, Bakker S, Dippel D. Efficacy of the epidural blood patch for the treatment of post lumbar puncture headache BLOPP: A randomised, observer-blind, controlled clinical trial. BMC Neurol. 2005;5:12. - PMC - PubMed
    1. Davies JM, Murphy A, Sullivan GO, Smith M. Subdural hematoma after dural puncture headache treated by epidural blood patch. Br J Anaesth. 2001;86:720–3. - PubMed
    1. Desai MJ, Dave AP, Martin MB. Delayed radicular pain following two large volume epidural blood patches for post-lumbar puncture headache: A case report. Pain Physician. 2010;13:257–62. - PubMed