SPHENOPALATINE BLOCK RELIEVES POST DURAL PUNCTURE HEADACHE

Md. Fazlul Haque*, Md. Rafiqul Alam Talukder, Mohammad Mahbube Mustafa, Kamal Ahmed Chowdhury, Nilu Sharmin Chowdhury, Md. Waheed Murshed, Fakhruddin Ahmed and Mohammad Jakir Hossen Mollick

ABSTRACT

Introduction: The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging, however, EBP is an interventional procedure with the risk of bleeding, infection, and adverse neurological effects. Objective: To evaluate the sphenopalatine Block relieves post dural puncture headache. Methods: This prospective study was conducted at General Hospital and different Clinics, Tangail, Bangladesh from July 2020 to June 2021. Randomization was performed using the random number generator available at https://www.random.org. All the patients were women and sample size thirty eight (n=38). Patients divided were two groups: Group 1 (n=19): Takes paracetamol, Tramadol hydrochoride, caffeine, releaves pain 1- 2 days. Group 2 (n=19): Takes sphenopalatine Block, relief pain within 1/2 hour. Results: There was no statistically significant difference between the 2 groups in terms of age, height, weight, or body mass index. The mean Comparison of response to treatment (good & excellent) in both groups. However, the mean pain relieve at the one to three days Sphenopalatine Block group were significantly higher compared to Paracetamol, Tramadol Hydrochoride, Caffeine group ( p < 0.001). Conclusion: Post dural puncture headache is directly related to the size and type of the spinal needle used. The study concluded that the incidence of post dural puncture headache can be reduced to minimum with the use of small sized needles and proper technique of spinal anesthesia by an experienced anesthesiologist. A unilateral SPGB is a rapid and effective method to treat PDPH. However, the safety of this technique requires further research due to complications encountered, including a seizure.

Keywords: Analgesia, Post-Dural Puncture Headache, Sphenopalatine Block, Lignocaine.