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Comparative evaluation of conservative management and sphenopalatine ganglion block for postdural puncture headache: A randomized controlled trial

1 Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India
2 Department of Anesthesia and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
3 Department of Neuro-Anesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Chandrakant Prasad,
Department of Neuro.Anaesthesia and Critical Care, All India Institute of Medical Sciences, 33/7, Gautam Nagar, New Delhi - 110 049
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/BJOA.BJOA_127_20

Background: Postdural puncture headache (PDPH) is a well-known iatrogenic and distressing complication of a subarachnoid block. In this study, we aimed to see if the sphenopalatine ganglion block (SPGB) is beneficial for the treatment of PDPH in comparison to conservative management or not. Patients and Methods: This prospective, randomized, observational study registered in the Clinical Trials Registry of India (CTRI/2018/02/011883). We included 60 patients, divided into three groups of 20 each. Group C patients were managed conservatively. Group L4 patients were given SPGB with 4% lignocaine per SPGB. Group L10 patients were given SPGB with lignocaine 10% puffs. The patients were assessed at predefined durations for Visual Analog Scale (VAS) score, readiness to discharge, and feel-good index. SPSS 20.0 software was used for data analysis. Results: There was a statistically significant reduction in VAS score and mean treatment duration in group L4 and group L10 in comparison to group C. At 72 h of treatment, 5.26% of Group C patients, 88.89% of Group L4, and 95% of Group L10 patients were found ready to discharge. The feel-good index was assessed after 15 min of treatment was found best in Group L10, followed by L4 and C groups. Conclusion: SPGB increases the proportion of patients ready to discharge at 72 h of treatment. Lignocaine 10% is more effective than lignocaine 4% solution for SPGB. SPGB decreases the hospital stay, hence cost-effective.

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