Sphenopalatine Ganglion Block for Postdural Puncture Headache

Study Overview
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Brief Summary
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Background: Postdural puncture headache (PDPH), which is one of the complications of spinal anesthesia, is a condition that negatively affects the quality of life of patients, causes late mobilization and prolonged hospital stay. Sphenopalatine ganglion block (SGB) has created a minimally invasive, easy, and safe treatment alternative. Objective: Evaluating the effectiveness of topical SGB on PDPH treatment. Design: Retrospective observational study Setting: Single center tertiary level of care hospital study. The files of PDPH patients between Jan 2018 and Jan 2020 were scanned. Patients: PDPH patients aged 18-65 are included and any patients with primary/secondary headache history are excluded. Main outcome measures: Patients were divided into 2 groups. The group that given only conservative treatment was named as Group C, and the group of patients who had additionally been applied SGB was named as Group SGB. Headache severity was measured with Visual Analogue Scale (VAS) at the 1st,3rd, 12th and 24th hours of the treatment, in supine and upright position.

Official Title
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Effectiveness of Sphenopalatine Ganglion Block on Postdural Puncture Headache Treatment: A Retrospective Observational Study

Conditions
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Postdural Puncture Headache

Intervention / Treatment
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* Other: Conservative Treatment for Postdural Puncture Headache


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-65 years-old not having any headache diagnosis (G44 and subgroup according to the International Classification of Diseases-10 classification), developed PDPH according to the International Headaches Classification after the neuraxial procedure Exclusion Criteria: history of primary headaches such as migraine, cluster type, tension type secondary headache such as preeclampsia / eclampsia, cerebral venous thrombosis, stroke, ruptured aneurysm, hypertensive encephalopathy, pituitary apoplexy, meningitis and subarachnoid hemorrhage any local or systemic infection

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group C<br>Postdural puncture headache patients treated with Conservative treatment | Other: Conservative Treatment for Postdural Puncture Headache<br>* The patients in Group C were given continuous bed rest in the supine position, 3000 mL daily hydration, 6 mg kg-1 aminophylline , 2 g day-1 paracetamol and 65 mg day-1 caffeine as conservative treatment. Topical SGB was applied to patients in Group SGB in addition to conservative treatment.<br>* Other names: Sphenopalatine Ganglion Block;|
| Group SGB<br>Postdural puncture headache patients treated with Sphenopalatine Ganglion Block and conservative treatment | Other: Conservative Treatment for Postdural Puncture Headache<br>* The patients in Group C were given continuous bed rest in the supine position, 3000 mL daily hydration, 6 mg kg-1 aminophylline , 2 g day-1 paracetamol and 65 mg day-1 caffeine as conservative treatment. Topical SGB was applied to patients in Group SGB in addition to conservative treatment.<br>* Other names: Sphenopalatine Ganglion Block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Headache in Supine Position | Headache severity changes with Visual Analogue Scale (VAS, 0-10, 0: no pain, 10:worst pain) | 1st, 3rd, 12th and 24th hours of follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Headache in Prone Position | Headache severity changes with Visual Analogue Scale (VAS, 0-10, 0: no pain, 10:worst pain) | 1st, 3rd, 12th and 24th hours of follow-up | 
| Successfully treated patients ratio | At the 24th hour of their follow-up, all patients with a VAS>3 (Visual Analogue Scale) headache in an upright position are considered as unsuccessful treatment and are directed to the epidural blood patch procedure. Both groups will be compared with successfully treated patients ratios. | 24th hour of follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sphenopalatine Ganglion Block, Postdural Puncture Headache