1.Sphenopalatine ganglion block for relieving postdural puncture headache: technique and mechanism of action of block with a narrative review of efficacy.
Abhijit S NAIR ; Basanth Kumar RAYANI
The Korean Journal of Pain 2017;30(2):93-97
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. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients. EBP can be still considered if an SPG block is not able to alleviate pain due to PDPH.
Blood Patch, Epidural
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Ganglia, Parasympathetic
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Ganglion Cysts
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Headache
;
Humans
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Pain Management
;
Post-Dural Puncture Headache*
;
Pterygopalatine Fossa
;
Sphenopalatine Ganglion Block*
2.Efficacy of bilateral greater occipital nerve block in postdural puncture headache: a narrative review
Abhijit S NAIR ; Praveen Kumar KODISHARAPU ; Poornachand ANNE ; Mohammad Salman SAIFUDDIN ; Christopher ASIEL ; Basanth Kumar RAYANI
The Korean Journal of Pain 2018;31(2):80-86
The Epidural blood patch is considered the gold standard for managing postdural puncture headache when supportive measures fail. However, it is a procedure which can lead to another inadvertent dural puncture. Other potential adverse events that could occur during a blood patch are meningitis, neurological deficits, and unconsciousness. The bilateral greater occipital nerve block has been used for treating chronic headaches in patients with PDPH with a single injection. This minimally invasive, simple procedure can be considered for patients early, along with other supportive treatment, and an epidural blood patch can be avoided.
Blood Patch, Epidural
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Headache Disorders
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Humans
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Meningitis
;
Nerve Block
;
Pain Management
;
Post-Dural Puncture Headache
;
Punctures
;
Ultrasonography
;
Unconsciousness