Sphenopalatine ganglion block in combination with greater and lesser occipital nerve blocks for the management of post dural puncture headache

Urits, Ivan; Viswanath, Omar; Orhurhu, Vwaire; Petro, Julie; Cai, Viet

doi:10.1016/j.jclinane.2018.09.015

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Recently, the use of SPGB in combination with greater and lesser occipital nerve blocks has been suggested for the management of PDPH. [22] The small sample size of our study is the primary limitation; however, the VAS scores at the fourth hour were significantly different. Clinical trials with a larger sample size are needed to support our results.…”

Section: Discussionmentioning

confidence: 78%

Transnasal sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric population

Yılmaz¹

2020

South Clin Ist Euras

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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, 12 th hour, and 24 th 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). 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.

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Section: Discussionmentioning

confidence: 78%

Transnasal sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric population

Yılmaz¹

2020

South Clin Ist Euras

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“…Peripheral nerve blocks appear to offer a safe and effective treatment option for patients suffering from these difficult conditions. these nerve blocks have proven to be useful for a variety of headache disorders including postdural puncture headaches as well as occipital neuralgia and cervical headaches [6][7][8]. Our patient demonstrated significant improvement with these safe and relatively easy to perform injections.…”

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confidence: 58%

Interventional pain management for a patient with chronic post-traumatic headaches after a traumatic brain injury

Hasoon¹,

Urits²,

Berger³

et al. 2021

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“…Growing numbers of various medications and (non)invasive procedures have been discussed to be beneficial in the management of PDPH, including intravenous neostigmine and atropine [21], epidural morphine [22], acupuncture [23,24], greater occipital nerve block, or sphenopalatine ganglion block [25][26][27][28][29][30]. We demonstrated in a case report that the noninvasive nasal administration of lidocaine using a mucosal atomization device (MAD) provides immediate and persisting symptom relief in obstetric patients suffering from PDPH [31].…”

Section: Introductionmentioning

confidence: 99%

Intranasal Lidocaine Administration via Mucosal Atomization Device: A Simple and Successful Treatment for Postdural Puncture Headache in Obstetric Patients

Siegler,

dos Santos Pereira,

Keßler

et al. 2023

Biomedicines

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(1) Background: Postdural puncture headache (PDPH) remains a serious complication in obstetric patients. While the epidural blood patch represents the current gold standard in therapy, a growing number of alternative measures are thought to be beneficial for clinical management. The purpose of this study was to retrospectively analyze the efficacy of intranasal lidocaine administration to treat PDPH in obstetrics at our university hospital; (2) Methods: A retrospective analysis of the medical records of patients with PDPH has been performed focusing on the techniques of administration, dosing, treatment duration, impact on pain intensity as well as side effects of intranasal lidocaine; (3) Results: During the study period, 5610 obstetric patients received neuraxial anesthesia, of whom 43 (0.77%) developed PDPH. About one third of the patients with PDPH after spinal anesthesia (n = 8), epidural anesthesia (n = 5) or both (n = 2) were treated with intranasal lidocaine. Lidocaine was administered either via gauze compresses (GC, n = 4), a mucosal atomization device (MAD, n = 8) or with a second-line mucosal atomization device due to low gauze compress efficacy (n = 3). All patients treated with lidocaine refused the epidural blood patch. Nebulization of lidocaine resulted in a significant reduction in pain intensity after the first dose (p = 0.008). No relevant side effects developed except sporadic temporal pharyngeal numbness. The utilization of the mucosal atomization device averted the necessity for an epidural blood patch, whether employed as the primary or secondary approach; (4) Conclusions: Our data imply that the mucosal atomization device enhances the efficacy of intranasal lidocaine administration in obstetric patients suffering from PDPH.

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Sphenopalatine ganglion block in combination with greater and lesser occipital nerve blocks for the management of post dural puncture headache

Cited by 7 publications

References 5 publications

Transnasal sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric population

Transnasal sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric population

Interventional pain management for a patient with chronic post-traumatic headaches after a traumatic brain injury

Intranasal Lidocaine Administration via Mucosal Atomization Device: A Simple and Successful Treatment for Postdural Puncture Headache in Obstetric Patients

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