Abotaleb et al. 20223030 Abotaleb AM, ElSharkawy MS, Almawardy HG. Bilateral sphenopalatine ganglion block with adrenaline additive for post-dural puncture headache in orthopedic patients: A randomized controlled trial. Egypt J Anaesth. 2022;38:305-9.
|
RCT (Open labelled) |
60 |
38.53 (13.55)/ 41.67 (12.53) |
43.3%/ 36.7% |
(30) B/L SPGB with applicator saturated with Lignocaine 4% + adrenaline (1/ 2000000) in each nostril, NA, 5-min |
(30) (Conservative) PCM 1 gm IV QID × 3day |
SA/ Lower limb surgeries |
NS/NS |
IV PCM 1 gm followed by IV Diclofenac 75 mg/12h if NRS > 4 after 2h |
Inadequate pain relief after 72h |
VAS ( 0 ‒10 cm) after 30 min, 1h, 2h, 6h, 12h, 24h, rescue treatment, treatment failure, adverse effects |
Bohara et al. 20223131 Bohara C, Maharjan R, Regmi S, Regmi G, Singh AK, Shrestha A. Sphenopalatine Ganglion Block versus Conservative Management for Post Dural Puncture Headache in Cesarean Section. Nepal J Health Sci. 2022;2:22-6.
|
RCT (Open labelled) |
40 |
24.1 (3.09)/ 24.25 (2.59) |
NS/NS |
(20) B/L SPGB with applicator saturated with Lignocaine 4%, NA, 5-min
rest + abdominal binder
|
(20) (Conservative) oral codeine+ paracetamol X TDS + caffeine + oral fluid + bed SA and epidural/ LSCS |
NS/NS |
IV tramadol if NRS > 7 |
NS |
|
NRS (0‒100) after 10 min, 4h, 8h |
Jespersen et al. 20203232 Jespersen MS, Jaeger P, Ægidius KL, et al. Sphenopalatine ganglion block for the treatment of postdural puncture headache: a randomised, blinded, clinical trial. Br J Anaesth. 2020;124:739-47.
|
RCT (Triple blind) |
40 |
35.24 (26.32)/ 36.42 (23.94) |
70%/70% |
(20) B/L SPGB with Lignocaine 4% + Ropivacaine 0.5% (1:1), 1 mL, 10-min |
(20) B/L SPGB with Saline |
LP/ SA/ epidural/ Surgical or non-surgical procedure |
Traumatic/ atraumatic or both/ 18‒ 27G |
Repeat SPG block if VAS ≥ 30 mm |
Not relieved after rescue block |
VAS ( 0 ‒100 cm) after 30 min and NRS (0‒ 100) at 1h and 7 days, rescue treatment, treatment failure, adverse effects |
Kumar et al. 20213333 Kumar R, Verma VK, Swati Prasad C. Comparative evaluation of conservative management and sphenopalatine ganglion block for postdural puncture headache: A randomized controlled trial. Bali J Anesthesiol. 2020;4:183.
|
RCT (Open labelled) |
40 |
35.50 (12.16)/ 36.58 (12.91) |
NS/NS |
(20) B/L SPGB with Lignocaine 4%, 1.5 mL, 10-min |
(20) Conservative (PCM+ tramadol+ caffeine + oral fluid+ bedrest) |
SA/ Various surgeries |
Quincke needle/ 26G |
Respective treatment repeated if pain not relieved after 1h of SPG Block |
Not relieved after repeat treatment |
VAS ( 0 ‒10 cm), treatment failure |
Mowafi et al. 20223434 Mowafi MM, Abdelrazik RA. Efficacy and efficiency of sphenopalatine ganglion block for management of post-dural puncture headache in obstetric patients: a randomized clinical trial. Ain-Shams J Anesthesiol. 2022;14:1-8.
|
RCT (Open labelled) |
40 |
28.7 (3.7)/ 27.5 (3.0) |
100%/ 100% |
(20) B/L SPGB with Lignocaine 2% + dexamethasone 4 mg, (2 mL + 1 mL), 5-min |
(20) (Conservative) PCM 1 gm IV TDS × 1day |
SA/LSCS |
NS/26 G |
IV Ketorolac 30 mg with a maximum dose of 120 mg. day-1 if NRS > 4 after 2h |
Inadequate pain relief after 24h |
NRS (0‒100) after 30 min, 1h, 2h, 4h, 6h, 8h, 12h, 24h, treatment failure, adverse effects |
Nazir et al. 20213535 Nazir N, Saxena A, Asthana U. Efficacy and Safety of Trans-nasal Sphenoid Ganglion Block in Obstetric Patients With Post-dural Puncture Headache: A Randomized Study. Cureus. 2021;13: e20387.
|
RCT (Single blind) |
20 |
28 (NS)/ 27.5 (NS) |
100%/100% |
(10) Applicator saturated with Ligno-caine 2% in posterior nasopharynx followed by B/L SPGB with Lignocaine 2%, 1 mL, 10-min |
(10) Two puffs of Lignocaine 10% in each nostril |
SA/LSCS |
NS/NS |
Injection Diclofenac IV 75 mg if VAS ≥5 |
Not relieved after treatment (VAS ≥8) |
VA S ( 0 ‒10 cm) after 30 min, 1h, 6h, 12h, 24h, rescue treatment, treatment failure, adverse effects |
Puthenveettil et al. 20183636 Puthenveettil N, Rajan S, Mohan A, Paul J, Kumar L. Sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric patients: An observational study. Indian J Anaesth. 2018;62:972-7.
|
RCT (Open labelled) |
20 |
NS/NS |
100%/ 100% |
(10) B/L SPGB with Lignocaine 2%, NA, 5-min |
(10) (Conservative) PCM 1 gm TDS for 1day followed by addition of inj. Diclofenac 75 mg BD |
SA/LSCS |
NS/ NS |
Conservative treatment (PCM 1 gm and Diclofenac 75 mg) if NRS > 4 |
Inadequate pain relief after conservative treatment for 3 days. |
NRS (0-‒10) after 30 min, 1h, 2h, 4h, 6h, 8h, 12h, 24h |
Yilmaz et al. 20203737 Yɩlmaz M, Kɩlɩç Yɩlmaz V, et al. Transnasal Sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric population. South Clin Ist Euras. 2020;31:335-9.
|
RCT (Open labelled) |
21 |
26.9 (5.2)/ 28.4 (5.8) |
100%/ 100% |
(10) U/L SPGB with 10% Lignocaine, 2 mL, 15-min |
(10) (Conservative) normal saline 1000 ml over 4h, MgSO4 1500 mg, The-ophylline 200 mg, PCM 1000 mg) |
SA/LSCS |
NS/NS |
NS |
NS |
VAS (0‒10 cm) after 12 h, 24 h, adverse effects |
Youssef et al. 20213838 Youssef HA, Abdel-Ghaffar HS, Mostafa MF, Abbas YH, Mahmoud AO, Herdan RA. Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial. Pain Physician. 2021;24:E443-51.
|
RCT (Single blind) |
100 |
31.5 (5.8)/ 30.9 (5.8) |
100%/ 100% |
(46) Applicator with Lidocaine 2% in posterior nasopharynx followed by B/L SPGB with Lignocaine
2% + dexamethasone 4 mg (2 mL + 1 mL), 10-min
|
(47) B/L GON block with same drug composition |
SA/LSCS |
Quincke needle/ 26G |
PCM 1g IV Followed by 2nd rescue block after 24 hours |
Inadequate pain relief after 2nd block (NRS ≥4) |
NRS (0‒100) after 30 min, 1h, 2h, 6h, 12h, 24h, rescue treatment, treatment failure, adverse effects |