Anaesthesia
Conditions
Interventions
bilateral greater and lesser occipital nerves block
Sponsors
Faculty of Medicine menoufia univeristy
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: - Patients aged =18 years of both genders, of American Society of Anesthesiologists (ASA) physical status class I or II who have a history of spinal and/or epidural anesthesia complaining of headache not responding to conventional medical treatment and fulfilling the criteria of PDPH (fronto-occipital dull throbbing headache developing within 5 days of neuraxial block, exacerbated in upright position and is relieved by lying down, with any of the following associations neck stiffness, nausea, vomiting, dizziness, visual disturbances such as photophobia or diplopia, and/or auditory symptoms such as tinnitus). - Headache NRS =4 or modified lybecker score =2 on assuming upright position, whichever is present
Exclusion criteria
Exclusion criteria: • Patients who had recent nasal trauma, deformity, surgery or epistaxis. • Local infection • Patients with fever or coagulopathy. • Poor echogenic window hindering appropriate Trans Cranial Doppler examination. • Patients with cardiovascular, neuropsychiatric or cerebrovascular diseases • Opioid dependence. • Uncooperative patients. • Patient refusal. • Intellectual disabilities or those who cannot understand or report NRS. • Allergy to any drug used in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is the PDPH severity as assessed by NRS in upright position (for 15 minutes) 30 minutes after the block | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcomes include patient satisfaction, post block analgesic consumption, need to rescue block | — |
Countries
Egypt
Contacts
Public ContactOla Saeed Mohammed
Lecturer of critical care medicine Faculty of Medicine Menoufia University
Outcome results
None listed