ESRA19-0386 Transnasal sphenopalatine ganglion block for treatment of postdural puncture headache in obstetric patients

Ribeiro, Matheus A. O.; Pacheco, Jânia

doi:10.1136/rapm-2019-esraabs2019.320

Cited by 1 publication

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“…Seventeen patients were included from case reports and case series, 42 patients included from a retrospective observational study, and 9 patients included from a prospective observational study. [ 25 26 27 28 29 30 31 32 33 34 ] All enrolled patients were diagnosed with PDPH after obstetric neuraxial block. Fifty-two of enrolled patients underwent an epidural insertion for labor analgesia, two of them had an emergency cesarean section (CS).…”

Section: Resultsmentioning

confidence: 99%

“…Eight case reports and case series. [ 26 27 28 29 30 31 32 33 ] One retrospective observational study with a sample size of 81 patients in which 42 of them (51%) underwent SPGB. [ 25 ] One prospective observational study with a sample size of 20 patients in which 10 of them (50%) underwent SPGB and one patient was lost to be followed up.…”

Section: Methodsmentioning

confidence: 99%

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The efficacy of sphenopalatine ganglion block for the treatment of postdural puncture headache among obstetric population

2022

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Background: Postdural puncture headache (PDPH) is a common complication among parturients who had undergone obstetric neuraxial block. Epidural blood patch is the current gold standard treatment for PDPH, although it is an invasive procedure. We conducted this systematic review to assess the efficacy of sphenopalatine ganglion block (SPGB) as a noninvasive treatment of PDPH. Methods: Relevant reports were searched from Google Scholar, PubMed, Science Direct, and Scopus from the inception of the databases to November 30, 2020. A total of 10 reports found to be related to SPGB for the treatment of PDPH in the obstetric population were enrolled. Significant relief of headache with no further intervention and initial relief of headache that requires further interventions were considered as the primary outcomes. The secondary outcome was the complications after SPGB. Results: A total of 68 patients were identified. We found that 41 of 68 patients (60.3%) had effective management with significant relief of headache with no further interventions needed. Moreover, a total of 27 of 68 patients (39.7%) had initially effective management that needed further interventions. The use of 2% lidocaine was found to be the most effective among all used local anesthetics with 85.7% effective management. Furthermore, parturients who developed PDPH after spinal anesthesia responded to SPGB better than other obstetric neuraxial techniques. Conclusions: This systematic review showed that SPGB is a promising treatment modality for the management of PDPH with no reported complications. Before recommending this technique for treating PDPH, we are calling for randomized clinical trials to prove its efficacy.

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