Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2020.09.002
Brazilian Journal of Anesthesiology
Case Report

Self-applied sphenopalatine ganglion block for postdural puncture headache: four case reports

Bloqueio do gânglio esfenopalatino autoaplicado para cefaléia pós-punção dural: relato de quatro casos

Andres Rocha Romero, Priodarshi Roychoudhury, Rodrigo Benavides Cordero, Maynor Lopez Mendoza

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Abstract

Background and objectives
The Sphenopalatine Ganglion Block (SGB) is an effective, low-risk treatment option for Postdural Puncture Headache (PDPH) refractory to conservative management.

Case report
This report presents four complex cases of patients with headache related to low cerebrospinal fluid pressure. Three of them were successfully treated with the application of local anesthetic topical drops through the nasal cavity.

Conclusion
The novel approach described in this report has minimal risks of discomfort or injury to the nasal mucosa. It is quick to apply and can be administered by the patient himself.

Keywords

Sphenopalatine ganglion block,  Postdural puncture headache,  Epidural blood patch,  Pain management,  Lidocaine

Resumo

Justificativae objetivos
O Bloqueio do Gânglio Esfenopalatino (BGEP) é opção de tratamento efetivo associado a baixo risco para Cefaleia Pós-Punção Dural (CPPD) refratária às medidas conservadoras.

Relato de caso
Este relato apresenta quatro pacientes com alta complexidade que apresentaram cefaleia relacionada à baixa pressão do líquido cefaloraquidiano. Três pacientes foram tratados com sucesso pela instilação de gotas de anestésico local tópico na cavidade nasal.

Conclusões
A nova abordagem descrita neste relato apresenta riscos mínimos de desconforto ou lesão à mucosa nasal. A aplicação é rápida e pode ser administrada pelo próprio paciente.

Palavras-chave

Bloqueio gânglio esfenopalatino,  Cefaleia pós-punção dural,  Tampão sanguíneo peridural,  Manejo de dor,  Lidocaína

References

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