Transnasal Sphenopalatine Ganglion Block For Treatment of Post-Dural Puncture Headache in Obstetric Population

Abstract

INTRODUCTION[|]Pain control for a post-dural puncture headache (PDPH) can be challenging. Epidural blood patching (EBP) is recommended; however, EBP is an interventional procedure with the risk of bleeding, infection, and adverse neurological effects. The aim of this study was to evaluate the effects of a transnasal sphenopalatine ganglion block (SPGB) as supportive PDPH treatment.[¤]METHODS[|]Pregnant women undergoing a cesarean section under spinal anesthesia who developed PDPH were included in this prospective randomized study. The enrolled subjects were randomly assigned to 2 groups: a medical treatment group (n=10) and a group that would receive medical treatment with the addition of SPGB (n=10). Visual analog scale (VAS) scores were recorded at the time of admission, and at 4, 12, and 24 hours after treatment.[¤]RESULTS[|]There was no statistically significant difference between the 2 groups in terms of age, height, weight, or body mass index. The mean VAS values at the baseline, 12th hour, and 24th hour were similar between the groups. However, the mean VAS score at the fourth hour was significantly lower in the block group (p=0.002).[¤]DISCUSSION AND CONCLUSION[|]A unilateral SPGB is a rapid and effective method to treat PDPH. However, the safety of this technique requires further research due to complications encountered, including a seizure.[¤]

Keywords

• post-dural puncture headache
• sphenopalatine ganglion block; spinal anesthesia.