Sphenopalatine Ganglion Block for Management of Post- Dural Puncture Headache in Obstetric Patients

Ain Shams University

Status: Completed

Conditions: Post-Dural Puncture Headache

Treatments: Procedure: Sphenopalatine ganglion block; Drug: paracetamol

Study type: Interventional

Funder types: Other

Identifiers

NCT04793490

FMASU R 12/2021

Details and patient eligibility

About

The purpose of this trial is to study the efficacy and efficiency of sphenopalatine ganglion block for management of post dural puncture headache in obstetric patients

Full description

Background and objectives: Post dural puncture headache(PDPH) is a common complication of lumbar puncture, it is likely due to the loss of cerebrospinal fluid into the epidural space through the dural tear. The prevalence of PDPH is higher in pregnant women.Sphenopalatine ganglion block (SPGB) is a non-invasive intervention with minimal adverse effects, it is indicated in acute and chronic facial/head pain like cluster headache, trigeminal neuralgia, post herpetic neuralgia and pain due to head and neck cancer.SPGB can be performed by different approaches:transnasal,transoral ,sub zygomatic and lateral infratemporal.Transnasal is the easiest, least invasive approach which can be done at bedside.

The objective of this trial is to study the efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients.The following will be recorded: pain score will be assessed using the numeric rating pain scale(NRS),heart rate and mean arterial pressure, onset and duration of analgesia, total dose of ketorolac, duration of hospital stay and patient satisfaction

Enrollment: 40 patients

Sex: Female

Ages: 21 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Female patients ASA I or II post caesarean section
• Body weight between 60-100 kg
• Active PDPH within days after spinal anesthesia not relieved with standard treatment such as, intravenous fluids, bed rest and caffeine.

Exclusion criteria

• Patient refusal to participate in the study
• Body mass index >35kg/m2
• Patients with :coagulopathy ,nasal septal deviation,polyp
• History of nasal bleeding
• Allergy to local anesthetic

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

Group A (Control group)

Other group

Description:

Patients will receive paracetamol 1 g thrice daily intravenously

Treatment:

Drug: paracetamol

Group B (Sphenopalatine ganglion block group)

Active Comparator group

Description:

patients will receive sphenopalatine ganglion block via transnasal approache by a cotton tipped applicator soaked in 2%lignocaine with 4 mg dexamethasone

Treatment:

Procedure: Sphenopalatine ganglion block