Treatment of postdural puncture headache: clinical case

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The article describes a clinical case of the successful use of transnasal pterygopalatine ganglion blockade for the treatment of postdural puncture headache. The conditions for the application of this technique, the mechanism of its action, and the results are discussed. Results reveal the simplicity of the technical implementation of pterygopalatine ganglion blockade and the almost absent contraindications to its use, except for cases involving individual intolerance to topical anesthetic drugs. Hence, the technique can be an effective method for the complex therapy of postpunctional pain.

作者简介

Vladimir Glushchenko

N.N. Petrov National Medical Research Center of Oncology

编辑信件的主要联系方式.
Email: spbgmaanestez@mail.ru
ORCID iD: 0000-0003-2638-5853
SPIN 代码: 1274-9977

MD, PhD, Professor, Head of Scientific department of Anesthesiology, Intensive Care and Algology

俄罗斯联邦, 68, Leningradskaya st., Saint Petersburg, 197758

Maxim Gruzdov

N.N. Petrov National Medical Research Center of Oncology

Email: m.s.gruzdov@mail.ru
ORCID iD: 0000-0001-7565-4808

anesthesiologist

俄罗斯联邦, 68, Leningradskaya st., Saint Petersburg, 197758

Irina Popel

N.N. Petrov National Medical Research Center of Oncology

Email: ira.popel.64@mail.ru
ORCID iD: 0000-0003-4295-549X

MD, anesthesiologist

俄罗斯联邦, 68, Leningradskaya st., Saint Petersburg, 197758

Sergei Rozengard

N.N. Petrov National Medical Research Center of Oncology

Email: rozengard.s@mail.ru
ORCID iD: 0000-0002-5042-830X

MD, Head of Anesthesiology Department and Intensive Care Unit

俄罗斯联邦, 68, Leningradskaya st., Saint Petersburg, 197758, Russia

参考

  1. Diener HC, Bendig M, Hempel V. Postpuncture headache. Fortschr Neurol Psychiatr. 1985;53(9):344–349. doi: 10.1055/s-2007-1001978 (In German).
  2. Arevalo-Rodriguez I, Munoz L, Godoy-Casasbuenas N, et al. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH). Cochrane Database Syst Rev. 2017;4:CD010807. doi: 10.1002/14651858.CD010807.pub2
  3. far.org.ru [Internet]. Clinical guidelines of the Federation of Anesthesiologists and Resuscitators “Post-puncture headache”, 2018 [cited 20 Jan 2021]. Available from: http://far.org.ru/recomendation?download=88%3Apunctheadache
  4. Borovskih NA, Rozengard SA. Development ofpostspinai headache: risk factors. Vestnik Sankt-Peterburgskogo universiteta. Serii 11, Meditsina. 2006;(1):102–109. (In Russ).
  5. Sluder G. The role of the sphenopalatine ganglion in nasal headaches. NY State J Med. 1908;(27):8–13.
  6. Grant R, Condon B, Hart I, Teasdale GM. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psychiatry. 1991;54(5):440–442. doi: 10.1136/jnnp.54.5.440
  7. Kent S, Mehaffey G. Transnasal sphenopalatine ganglion block for the treatment of postdural puncture headache in obstetric patients. J Clin Anesth. 2016;34:194–196. doi: 10.1016/j.jclinane.2016.04.009
  8. Dubey P, Dubey PK. Intranasal lignocaine spray for sphenopalatine ganglion block for postdural puncture headache. Saudi J Anaesth. 2018;12(2):364–365. doi: 10.4103/sja.SJA_680_17

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2. Fig. 1. Transnasal pterygopalatine ganglion block

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