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. 

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.

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.

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

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.