Early versus late sphenopalatine ganglion block with ropivacaine in postdural puncture headache: an observational study

Santos, Nelson S.; Nunes, Joana; Font, Maria L.; Carmona, Cristina; Castro, Maria Machado Barbosa de

doi:10.1016/j.bjane.2021.01.007

Cited by 7 publications

(10 citation statements)

References 10 publications

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“…The mechanism could be due to mechanical stimulation of the sphenopalatine ganglion since saline placebo also offered pain relief. In Santos et al (Santos et al 2021), 41 patients with PDPH had SPGB with ropivacaine 0.75%. Patients were divided into two SPGB groups: an early (less than 24 h after diagnosis) and a late (more than 24 h after diagnosis) group.…”

Section: Discussionmentioning

confidence: 98%

“…Only few studies have investigated the efficacy and safety of SPGB for treating the PDPH. Earlier studies showed that SPGB was a safe procedure, provided good pain relief after the block, and showed reduction in the need for EBP with overall high patient satisfaction (Candido et al 2013;Cohen et al 2018Cohen et al , 2009Cohen et al , 2001Jespersen et al 2020;Mehaffey 2015, 2016;Patel et al 2016;Puthenveettil et al 2018;Santos et al 2021;Takmaz et al 2021). All these studies were suggestive that the block could be useful.…”

Section: Introductionmentioning

confidence: 94%

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Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial

Mowafi

Abdelrazik

2022

Ain-Shams J Anesthesiol

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Background This clinical trial aimed to study the efficacy and efficiency of sphenopalatine ganglion block (SPGB) for the management of post-dural puncture headache (PDPH) in obstetric patients. A prospective randomized clinical trial was carried out on 40 patients with PDPH divided randomly into two equal groups. Paracetamol group (PG): The patients received 1 g of paracetamol three times per day intravenously for 1 day. If adequate pain relief was not achieved, rescue analgesia in the form of intravenous ketorolac was given. Block group (SPGBG): The patients received bilateral SPGB using 3 ml mixture of lignocaine with dexamethasone in each nostril. The pain score, heart rate, and mean arterial pressure were recorded. The onset of analgesia, duration of analgesia, adverse effects, total dose of ketorolac, patient satisfaction, and hospital stay for epidural blood patch (EBP) or hospital discharge after 24 h were also documented. Results The pain perception (numeric rating scale [NRS]) in the block group was generally lower throughout the study showing only highly significant difference till the first 2 h after the block with more rapid onset and longer duration of analgesia. The total dose of rescue analgesic in mg was significantly lower in the block group and hospital stay for EBP was significantly less in the block group with higher patient satisfaction. Conclusions PDPH can be treated effectively and rapidly with transnasal SPGB, which is a noninvasive, safe, and easy method with a low complication rate. Trial registration ClinicalTrials.gov, NCT04793490. Registered on March 11, 2021; https://clinicaltrials.gov/ct2/show/NCT04793490).

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 94%

Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial

Mowafi

Abdelrazik

2022

Ain-Shams J Anesthesiol

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“…Santos et al . [ 1 ] compared SPGB–early (<24 hours) intervention with 20 patients and late (>24 hours) intervention with 21 patients presenting with PDPH. One patient in late intervention had the need for EBP.…”

Section: Discussionmentioning

confidence: 99%

“…Post dural puncture headache (PDPH) is a severe and disabling complication of neuraxial anaesthesia posing challenging management with the incidence around 1–2%. [ 1 ] It affects post-operative course by affecting day-to-day activities, extends hospital stay. Conservative treatment includes fluid therapy, caffeine and analgesics.…”

Section: Introductionmentioning

confidence: 99%

A randomized control study to assess the efficacy of the sphenopalatine ganglion block in patients with post dural puncture headache

Karthik

Gayathri

Saravanan

et al. 2022

Saudi Journal of Anaesthesia

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Background: Post dural puncture headache (PDPH) delays discharge from hospital. We studied the efficacy of sphenopalatine ganglion (SPG) block, a novel technique in management of PDPH using 0.25% Ropivacaine. Methodology: Forty patients presenting with PDPH after urological procedures under spinal anaesthesia were randomized into two groups: Group C and Group S. Group C received conservative treatment with bed rest, adequate hydration and caffeine 200 mg 6 th hourly. Group S patients received SPG block (packing bilateral nostril for 10 minutes with 0.25% Ropivacaine). Inj Paracetamol 1 g IV was given as primary analgesic. Intravenous Diclofenac 75 mg was administered as rescue analgesic. Patients were monitored for 72 hours. Total analgesic requirement, time to attain adequate pain relief, headache pain score, patient satisfactory score were compared between the two groups. We compared the PDPH severity score for headache using 5-point scale method and patient satisfaction score using Likert-type scale. Results: Demographic data, onset of PDPH, needle size, intervention time were statistically insignificant. Total paracetamol consumption was significantly reduced in SPG group. Headache pain score was significantly low in Group S up to 54 hours. Patient satisfaction score was statistically better in Group S. Mean block onset time was 12 minutes. One patient in Group C required Epidural blood patch. Conclusion: SPG block is an effective alternative in managing patients with PDPH. The need for epidural blood patch is greatly reduced using SPG block. Procedural safety, immediate and sustained pain relief make it an evolving treatment modality for PDPH.

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“…The efficacy of ropivacaine for SPG block has been described in the literature. 16 , 17 , 18 However, no study has compared the duration of SPG block between lignocaine and ropivacaine. Because SPG block provides only symptomatic relief and has a limited duration of action, repeat procedures may be needed until the dural tear heals spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Transnasal sphenopalatine ganglion block for postdural puncture headache in obstetric patients: A Malaysian experience report

Kassim

Kamar

Zakariah

et al. 2022

Journal of Taibah University Medical Sciences

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Early versus late sphenopalatine ganglion block with ropivacaine in postdural puncture headache: an observational study

Cited by 7 publications

References 10 publications

Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial

Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial

A randomized control study to assess the efficacy of the sphenopalatine ganglion block in patients with post dural puncture headache

Transnasal sphenopalatine ganglion block for postdural puncture headache in obstetric patients: A Malaysian experience report

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