Effectiveness of sphenopalatine ganglion block on postdural puncture headache treatment

AIM: 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 and may cause catastrophic outcomes when not treated. Sphenopalatine ganglion block (SGB), which has taken its place in the literature in recent years, has created a minimally invasive, easy and safe treatment alternative. We aimed to evaluate the effectiveness of topical SGB on PSBA treatment. METHOD: After the approval of the ethics committee, the files of PSBA patients were scanned. The patients included in the study were divided into 2 groups. The group that given only conservative treatment was named as Group K, and the group of patients who had additionally applied sphenopalatine ganglion block at the beginning of conservative treatment (SGB) was named as Group S. Headache severity was measured with VAS (Visual Analogue Score). Headaches of the patients were recorded with VAS values at the 1st,3rd, 12th and 24th hours of the treatment, in the supine and upright position. The treatment success criterion was accepted as the severity of headache in the upright position at the 24th hour of the treatment, VAS= 3 and below. RESULTS: A total of 110 patients, 68 in Group K and 42 in Group S, who met the criteria, were included in this study. There was no statistically significant difference between the two groups in terms of age, gender, type of surgery applied, types of spinal needle used, and additional symptoms accompanying headache (p <0.05). The VAS values in upright position at 1st, 3rd,12th and 24th hours in Group S were found to be statistically significantly lower comparing to Group K (p <0.001). At the end of 24-hour follow-up the patients, 38 (90.5%) of 42 patients in Group S and 46 (67.6%) of 68 patients in Gruop K were succesfully treated . When the groups were compared in terms of treatment success, a statistically significant difference was found in favor of Group S (p <0.05). CONCLUSION: In the treatment of PSBA, we found that earlier analgesia is provided for a greater proportion of patients when SGB is applied in addition to conservative treatment. We came to a conclusion that, when topical SGB application, which is a minimally invasive, easy and safe method, is added to conservative treatment it provides a faster and more effective treatment for PDPH patients, thus it can reduce the need for epidural blood patch, which is an invasive procedure and can cause serious complications. Keywords: Analgesia, conservative treatment, postdural puncture headache, spinal anesthesia, sphenopalatine ganglion block.