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Topical sphenopalatine ganglion block is a
cheap, well-tolerated and safe option as it showed quick onset of headache
relief in post-dural puncture headache patients.
As per the recent analysis, sphenopalatine
ganglion block (SPGB) was found to be significantly effective than epidural
blood patch (EBP) in reducing headache in patients with post-dural puncture
headache.
Postdural puncture headache (PDPH) is a critical
debilitating problem related to unintended dural puncture. Generally, the
treatment of a devastating headache is done by EBP, but with certain serious
complications like paralysis and meningitis. Therefore, Shaul Cohen and
colleagues conducted a retrospective chart review to evaluate the efficacy of
SPGB to manage PDPH in comparison to EBP.
The patients taken for analysis were the
obstetric patients who were detected with PDPH (Jan 1997 to July 2014) due to
unintended dural puncture done with 17-gauge Tuohy needle for labour epidural.
The EBP group involved 39 and SPGB group included 41 patients. Before
initiating the treatment, headache severity, demographic features and
headache-related symptoms were collected. Both groups were compared for new treatment
complications, residual headache and recovery from related symptoms at 30
minutes, one h, 24 h, 48 h and one week after the treatment.
In the SPGB group, more patients exhibited
considerable relief from PDPH and related symptoms at 30 and one h post-treatment
as compared to EBP group (P < 0.01). The complications after the treatment
were noticed only in EBP group, which cleared up in 48 hours.
Cochrane Database Syst Rev
Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients: A Retrospective Review
Shaul Cohen et al.
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