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    Sphenopalatine ganglion block for postdural puncture headache


    Daniel Jolley.

    7 articles.

    Created February 22, 2017, last updated 18 days ago.

    Collection: 83, Score: 1581, Trend score: 0, Read count: 1581, Articles count: 7, Created: 2017-02-22 08:37:45 UTC. Updated: 2019-09-15 07:35:46 UTC.



    First described in 1909, and then used for treatment of various types of headache and facial pain, the sphenopalatine ganglion block may offer a novel, simple and less-invasive treatment for post-dural puncture headache.

    Very little has been published, primarily case studies, case series and retrospective audits. This limited data does however suggest that the technique may be as effective as the traditional epidural blood patch, though with significantly fewer risks.

    Larger studies are however needed to properly define the block's role in treating PDPH.

    Publications describe a trans-nasal approach, either sitting or supine. First topicalising with co-phenylcaine spray, then placing 2%-4% viscous lignocaine-soaked cotton-tipped applicators for 10 minutes, and finally repeated for a further 20 minutes. Success appears to range from 30-70%.

    The mechanism of action may result from parasympathetic blockade at the SPG, resulting in reversal of the cerebral vasodilation thought to be associated with post dural puncture headache.

    Daniel Jolley  Daniel Jolley
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