Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients

Primary tabs

SCIENCE
Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients
Key Take-Away: 

Postdural puncture headache (PDPH) is a frequently occurring headache due to unintended dural puncture while doing epidural catheter placement. The following study focused on managing PDPH using specific approaches, and one of those approaches is Topical Sphenopalatine Ganglion Block as Sphenopalatine Ganglion with multiple neural connections involving autonomic and sensory fibres, and accentuation of these autonomic fibres provides relief from headaches.

Introduction
Postdural puncture headache (PDPH) is a debilitating and severe issue of unintended dural puncture. Epidural blood patch (EBP) is the criterion-standard therapy for PDPH but may cause paralysis and meningitis. The comparison of sphenopalatine ganglion block (SPGB) efficacy to EBP for PDPH management was made by conducting a first-ever 17-year retrospective chart review.

 

Method
Obstetric patients who encountered PDPH from an accidental dural puncture from a 17-gauge Tuohy needle used for labour epidural from January 1997 to July 2014 were selected for the study. Headache severity, related symptoms and demographic characteristics were assembled before the operation. EBP and SPGB group comprised 39 and 42 patients, respectively. Both groups were compared for a residual headache, improving from related symptoms, and new therapy complexities at 30 minutes, 1, 24, 48 hours, and 1 week after the treatment.

 

Results
The SPGB group exhibited significant relief from PDPH and related symptoms 30 and 60 minutes postoperatively as compared to EBP (P < 0.01). The posttreatment complications were noticed only among the EBP group which all settled in 48 hours.

 

Conclusions
Numerous patients get quick relief from PDPH, without any side effect when treated with SPGB. By outcomes, SPGB is an inexpensive, well-tolerated and safe approach for PDPH. We believe that clinical trials will be carried in the future that will validate our conclusions and support us to promote SPGB for PDPH treatment before administering patients with EBP.

Source:

Regional Anesthesia and Pain Medicine

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/30063655

original title of article:

Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients: A Retrospective Review

Authors:

Shaul Cohen et al.

Therapeutic, Postdural Puncture Headache, Head, Retrospective Review, Efficacy, Safety, Tolerability
Log in or register to post comments