Self-applied sphenopalatine ganglion block for postdural puncture headache: four case reports

Rocha-Romero, Andrés; Roychoudhury, Priodarshi; Cordero, Rodrigo Benavides; Mendoza, Maynor Lopez

doi:10.1016/j.bjane.2020.09.002

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…In four adult patients with PDPH after one by lumbar puncture (without needle gauge), two by accidental perforation of the dura mater (without needle gauge), one CSF fistula associated with meningitis, were successfully treated by instillation of 2% plain lidocaine drops 1 mL (20 drops) into the nasal cavity, administered by the patient himself. 14 Using the title "SPG block in children for PDPH" in PubMed, Medline, Lilacs, Scielo, and Google Scholar no case was found in children under seven years of age, just a teenage case. Therefore, this is the first successful case with a child aged 3 years and 9 months.…”

Section: Discussionmentioning

confidence: 99%

Sphenopalatine ganglion block for headache after accidental dural puncture in a child: a case report

Imbelloni,

Claudio,

Prado

et al. 2023

JACCOA

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Background: PDPH is a well-recognized complication of anesthesia in the neuraxial. Few cases have been reported in children. EBP is more difficult in children, as it requires sedation or even general anesthesia. The SPG block is an effective, low-risk treatment option for PDPH refractory to conservative management. We will report a case of unnoticed accidental perforation of the dura mater, with the appearance of PHPD 48 hours after anesthesia, treated with SPG block. Case report: Female patient, aged 3 years and 9 months, weighing 20 kg, ASA I. Coagulogram and complete blood tests were normal. Abbreviation of fasting with orally 10 ml/kg of 12.5% maltodextrin between 2-4 hours before umbilical hernia correction. Monitoring, venoclysis (#22G), inhalation anesthesia with sevoflurane under the Baraka method. Asepsis and antisepsis, lumbar puncture with pediatric epidural needle (22G), injection 10 ml 0.25% levobupivacaine. The surgery duration is 40 minutes. PACU without motor blockage of the lower limbs. After 48 hours, she sought emergency care at the hospital with a typical PDPH after accidental puncture of the dura mater, without the anesthesiologist's perception. On the 5th postoperative day, the child presented refractoriness, leading to limitations in daily activities, SPG block with 1% lidocaine was performed with immediate success. Discharged home without a headache. Conclusion: Occurrence of PDPH after lumbar puncture in children is rare. SPG block has been an alternative for the use of EBP. The novel approach described in this report has minimal risks of discomfort or injury to the nasal mucosa. We believe that SPG block is a feasible, easy, safe, inexpensive, and well-tolerated treatment, being an option for the treatment of PDPH in children. Using five publishing sites this is the 1st SGP block in children.

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Section: Discussionmentioning

confidence: 99%

Sphenopalatine ganglion block for headache after accidental dural puncture in a child: a case report

Imbelloni,

Claudio,

Prado

et al. 2023

JACCOA

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“…The addition of steroids to LA in an SPG block has been reported to decrease the severity and frequency of cluster headaches. 21 , 22 …”

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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“…The effect of sphenopalatine ganglion block on post-Dural puncture headache was assessed by Rocha-Romero et al, 18 in 2020. They came up with the findings that most patients had adequate relief after nasal block.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sphenopalatine Block and Intravenous Paracetamol for the Treatment of Post-Dural Puncture Headache

Khan

Feroz

Iqbal

et al. 2022

PAFMJ

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Objective: To compare the effect of topical sphenopalatine block and intra venous Paracetamol in the management of post-Dural puncture headache. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar Pakistan, from Jan to Aug 2021. Methodology: This experimental study was conducted on 153 patients who underwent lumbar puncture for any procedure and then suffered from post-Dural puncture headaches. Patients were randomized into two groups. Group A received the topical sphenopalatine block, while group B received the intravenous Paracetamol three doses 12 hours apart. Headache was recorded on Numeric pain score (NPS) 24 hours after the surgical procedure. Comparison in pain relief was compared in both groups at 1 hour, 12 hours, 24 hours and 48 hours. Results: Out of 153 patients randomized into two groups, 76 (49.7%) were categorized into Group-A, and 77 (50.3%) were categorized into Group-B. 63 (41.2%) were male, while 90 (58.8%) were female. The mean age of patients included in our study was 34.34 ± 4.33 years. Gynaecological/obstetric procedures 70 (45.7%) were the most common indication for lumbar puncture in our study. At 1, 12, 24 and 48 hours, pain relief was statistically significantly better in Group-A than in Group-B (p- value<0.005). Conclusion: Sphenopalatine ganglionic block emerged as a better option for pain relief among patients suffering from post-Dural puncture headache than intravenous Paracetamol. In addition, immediate and short-term relief was better among patients who used sphenopalatine block.

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Self-applied sphenopalatine ganglion block for postdural puncture headache: four case reports

Cited by 4 publications

References 11 publications

Sphenopalatine ganglion block for headache after accidental dural puncture in a child: a case report

Sphenopalatine ganglion block for headache after accidental dural puncture in a child: a case report

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

Comparison of Sphenopalatine Block and Intravenous Paracetamol for the Treatment of Post-Dural Puncture Headache

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