-Original-

Transnasal Sphenopalatine Ganglion Block for Management of Postdural Puncture Headache in Non-Obstetric Patients

Suna Akın Takmaz¹, Mustafa Karaoğlan¹, Bülent Baltacı², Meltem Bektaş² and Hülya Başar²

¹Department of Algology, Ankara Research and Educational Hospital, Ankara, Turkey
²Department of Anesthesiology and Reanimation, Ankara Research and Educational Hospital, Ankara, Turkey

Background: This study investigated the efficacy and safety of transnasal sphenopalatine ganglion block (SPGB) for treatment of postural puncture headache (PDPH) in non-obstetric patients.
Methods: This retrospective study was conducted at the Ankara Research and Educational Hospital, in Turkey, and included 26 non-obstetric patients (age, ≥18 years) who were diagnosed with PDPH and unresponsive to conservative therapy or unable to continue it because of side effects. Transnasal SPGB was performed in each nostril. Pain severity was assessed with the Visual Analogue Scale (VAS) at 15 min, 30 min, 24 h, and 48 h after the procedure, while patients were seated. The patients were monitored for 48 h for adverse effects (AEs). Patient treatment satisfaction was assessed at 48 h after the procedure by using the Patient Global Impression of Change (PGIC) scale.
Results: Headache at 15 min post-procedure was relieved rapidly. At 24 h post-procedure, nearly half of patients (42.3%) had no pain, and all patients (100%) had a VAS score of <3. Nasal discomfort, throat numbness, and nausea were AEs reported after SPGB; however, these AEs were completely relieved at 24 h after the procedure. According to the PGIC scale scores at 48 h post-procedure, 73.1% of patients evaluated themselves as "much improved" and 26.9% evaluated themselves as "very much improved".
Conclusion: When PDPH does not respond to conservative treatment, it may be treated effectively with transnasal SPGB, which is a noninvasive, safe, well-tolerated, and straightforward method with a low complication rate.

J Nippon Med Sch 2021; 88: 291-295

Keywords
sphenopalatine ganglion block, postdural puncture headache, epidural blood patch

Correspondence to
Mustafa Karaoğlan, Department of Algology, Ankara Research and Educational Hospital, Altındağ, Ankara 06030, Turkey
mkaraoglan@gmail.com

Received, March 8, 2020
Accepted, July 31, 2020