Post-Dural Puncture Headache
Conditions
Keywords
Sphenopalatine ganglion block, Post-Dural Puncture Headache
Brief summary
The purpose of this trial is to study the efficacy and efficiency of sphenopalatine ganglion block for management of post dural puncture headache in obstetric patients
Detailed description
Background and objectives: Post dural puncture headache(PDPH) is a common complication of lumbar puncture, it is likely due to the loss of cerebrospinal fluid into the epidural space through the dural tear. The prevalence of PDPH is higher in pregnant women.Sphenopalatine ganglion block (SPGB) is a non-invasive intervention with minimal adverse effects, it is indicated in acute and chronic facial/head pain like cluster headache, trigeminal neuralgia, post herpetic neuralgia and pain due to head and neck cancer.SPGB can be performed by different approaches:transnasal,transoral ,sub zygomatic and lateral infratemporal.Transnasal is the easiest, least invasive approach which can be done at bedside. The objective of this trial is to study the efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients.The following will be recorded: pain score will be assessed using the numeric rating pain scale(NRS),heart rate and mean arterial pressure, onset and duration of analgesia, total dose of ketorolac, duration of hospital stay and patient satisfaction
Interventions
PROCEDURESphenopalatine ganglion block
Patients will receive the SPGB via the transnasal approache by a cotton tipped applicator soaked in lignocaine 2% with 4 mg dexamethasone
DRUGparacetamol
patients will receive paracetamol 1 g thrice daily intravenously
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
21 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Female patients ASA I or II post caesarean section * Body weight between 60-100 kg * Active PDPH within days after spinal anesthesia not relieved with standard treatment such as, intravenous fluids, bed rest and caffeine.
Exclusion criteria
* Patient refusal to participate in the study * Body mass index \>35kg/m2 * Patients with :coagulopathy ,nasal septal deviation,polyp * History of nasal bleeding * Allergy to local anesthetic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric rating pain score | First 24 hours after the procedure | Numeric rating pain score will be used to assess the efficacy of SPGB for treatment of PDPH |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total analgesic consumption | First 24 hours after the procedure | total dose of ketorolac will be calculated |
Countries
Egypt
Outcome results
None listed