scholarly journals Efficacy and Safety of Trans-nasal Sphenoid Ganglion Block in Obstetric Patients With Post-dural Puncture Headache: A Randomized Study

Cureus ◽  
2021 ◽  
Author(s):  
Nazia Nazir ◽  
Anupriya Saxena ◽  
Unnati Asthana
Keyword(s):  
Dural Puncture ◽  
Randomized Study ◽  
Efficacy And Safety ◽  
Ganglion Block ◽  
Post Dural Puncture Headache

scholarly journals Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial

2021 ◽  
pp. E443-E451
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Nerve Blocks ◽  
Neck Stiffness ◽  
Post Dural Puncture Headache ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Blood Patch

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

scholarly journals Bloqueo del ganglio esfenopalatino, una opción para el tratamiento de la cefalea postpunción dural

2020 ◽  
Vol 49 (4) ◽  
Author(s):  
Samuel da Rosa Sousa ◽  
Isadora Juliana Opolski ◽  
Marcio Grande Carstens ◽  
Paula Farías ◽  
Guilherme Voltolini ◽  
...  
Keyword(s):  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Therapeutic Failure ◽  
Supportive Treatment ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Post Dural Puncture Headache ◽  
Initial Approach ◽  
Blood Patch ◽  
Sphenopalatine Ganglion Block

Post-dural puncture headache is a complication of neuroaxial anesthesia. The initial approach consists of supportive treatment. In case of therapeutic failure, the epidural blood patch (PSE) is the treatment of choice. The case of a sphenopalatine ganglion block is presented for its management with good results.

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