Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial
Background Post dural puncture headache (PDPH) is a common condition that occurs following an accidental dural puncture. The work aimed to determine the efficacy and safety of analgesia of sphenopalatine ganglion block (SPB) (lidocaine 4% with adrenaline) for PDPH in orthopedic patients.Methods This...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2077051 |
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| author | Amany Mohamed Abotaleb Mohammed Said ElSharkawy Hussen Gamal Almawardy |
| author_facet | Amany Mohamed Abotaleb Mohammed Said ElSharkawy Hussen Gamal Almawardy |
| author_sort | Amany Mohamed Abotaleb |
| collection | DOAJ |
| description | Background Post dural puncture headache (PDPH) is a common condition that occurs following an accidental dural puncture. The work aimed to determine the efficacy and safety of analgesia of sphenopalatine ganglion block (SPB) (lidocaine 4% with adrenaline) for PDPH in orthopedic patients.Methods This randomized prospective open-label-controlled trial was conducted on 60 cases aged 18–60 years, both sexes American Society of Anesthesiologists (ASA) physical status I and II with severe PDPH during seven days after subarachnoid blockage for surgeries of lower limbs. Cases were randomized into two equal groups: Group MT: received medical treatment paracetamol 1 gm/6 hour daily, Group SPB: received SPB by using lidocaine 4% and adrenaline (1/2,000,000). The analgesia was effective if visual analogue scale (VAS) was < 4 in the first 48 hours. Patients with VAS ≥ 4 received diclofenac 75 mg/12 hour if pain was not controlled. Epidural blood patch was used in case of unrelieved pain after 3 days.Results There were significant quicker onset and longer duration of analgesia in group SPB compared to group MT (P = 0.001 and 0.03, respectively). VAS score was insignificantly different at baseline and 48 hours and was significantly lower in group SPB compared to group MT at 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h. The need for EBP was significantly lower in group SPB B than group MT (16.7% versus 46.7%).Conclusions SPB is an effective method for PDPH in orthopedic patients with quicker onset and longer duration of analgesia and lower VAS score compared to medical treatment. |
| first_indexed | 2024-12-11T18:00:43Z |
| format | Article |
| id | doaj.art-f6120560cc504b4bb8b729e687f47a65 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-11T18:00:43Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-f6120560cc504b4bb8b729e687f47a652022-12-22T00:55:53ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138130530910.1080/11101849.2022.2077051Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trialAmany Mohamed Abotaleb0Mohammed Said ElSharkawy1Hussen Gamal Almawardy2Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, EgyptAnesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, EgyptAnesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, EgyptBackground Post dural puncture headache (PDPH) is a common condition that occurs following an accidental dural puncture. The work aimed to determine the efficacy and safety of analgesia of sphenopalatine ganglion block (SPB) (lidocaine 4% with adrenaline) for PDPH in orthopedic patients.Methods This randomized prospective open-label-controlled trial was conducted on 60 cases aged 18–60 years, both sexes American Society of Anesthesiologists (ASA) physical status I and II with severe PDPH during seven days after subarachnoid blockage for surgeries of lower limbs. Cases were randomized into two equal groups: Group MT: received medical treatment paracetamol 1 gm/6 hour daily, Group SPB: received SPB by using lidocaine 4% and adrenaline (1/2,000,000). The analgesia was effective if visual analogue scale (VAS) was < 4 in the first 48 hours. Patients with VAS ≥ 4 received diclofenac 75 mg/12 hour if pain was not controlled. Epidural blood patch was used in case of unrelieved pain after 3 days.Results There were significant quicker onset and longer duration of analgesia in group SPB compared to group MT (P = 0.001 and 0.03, respectively). VAS score was insignificantly different at baseline and 48 hours and was significantly lower in group SPB compared to group MT at 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h. The need for EBP was significantly lower in group SPB B than group MT (16.7% versus 46.7%).Conclusions SPB is an effective method for PDPH in orthopedic patients with quicker onset and longer duration of analgesia and lower VAS score compared to medical treatment.https://www.tandfonline.com/doi/10.1080/11101849.2022.2077051Sphenopalatine ganglion blockepidural blood patchPost-Dural puncture headacheadrenaline |
| spellingShingle | Amany Mohamed Abotaleb Mohammed Said ElSharkawy Hussen Gamal Almawardy Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial Egyptian Journal of Anaesthesia Sphenopalatine ganglion block epidural blood patch Post-Dural puncture headache adrenaline |
| title | Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial |
| title_full | Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial |
| title_fullStr | Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial |
| title_full_unstemmed | Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial |
| title_short | Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial |
| title_sort | bilateral sphenopalatine ganglion block with adrenaline additive for post dural puncture headache in orthopedic patients a randomized controlled trial |
| topic | Sphenopalatine ganglion block epidural blood patch Post-Dural puncture headache adrenaline |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2077051 |
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