A case of post dural puncture headache following labour epidural analgesia, managed by sphenopalatine ganglion block
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20223147Keywords:
Postpartum headache, Epidural analgesia, PDPH, Sphenopalatine blockAbstract
Postpartum headache is a common complaint faced by most obstetricians, with over 39% of women having headache in the first postpartum week. With the increasing use of labour epidural analgesia, the incidence of postdural puncture headache (PDPH) due to inadvertent dural puncture is 0.5-1%. Most treatment modalities relieve the symptoms of PDPH by minimizing compensatory cerebral vasodilatation, or by sealing the dural puncture site. Treatment options include, conservative, pharmacological, and the gold standard, epidural blood patch (EBP). EBP is invasive and may result in rare however, severe complications. Sphenopalatine ganglion block (SPGB) has been proposed as a non-invasive intervention for PDPH, which has minimal adverse effects, which can be performed bedside. Here we are reporting a case of PDPH, following labour epidural analgesia which was effectively managed by a sphenopalatine block.
References
Weji BG, Obsa MS, Melese KG, Azeze GA. Incidence and risk factors of postdural puncture headache: prospective cohort study design. 2020;9:32.
Kyung-Hwa K. Postdural puncture headache. Korean J Pain. 2017;70(2):136-43.
Nair AS, Rayani BK. Sphenopalatine ganglion block for relieving postdural puncture headache: technique and mechanism of action of block with a narrative review of efficacy. Korean J Pain. 2017;30(2):93-7.
Hwa Yong S. Recent update on epidural blood patch. Anesth Pain Med (Seoul). 2022;17(1):12-23.
Sabharwal A, Stocks GM. Postpartum headache: diagnosis and management. Continuing Educat Anaesthesia Cri Care Pain. 2011;11(5):181-5.
Iga K, Murakoshi T, Kato A, Kato K, Terada S, Konno H. Repeat epidural blood patch at the level of unintentional dural puncture and its neurologic complications: a case report. JA Clin Rep. 2019;5:14.
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.
