Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.04.024
Brazilian Journal of Anesthesiology
Case Report

Sphenopalatine ganglion block for refractory COVID-19 headache: a descriptive case series

Bloqueio do gânglio esfenopalatino para cefaleia refratária pós-COVID-19: uma série de casos descritivos

Felipe Chiodini Machado, Gilson Carone Neto, Rebeca Santiago Duarte Carone

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Abstract

Coronavirus SARS-CoV-2 is responsible for the COVID-19 pandemic, and headache is reported in 6.5% to 34% of all cases. There is little published evidence on the pharmacological treatment of COVID-19 headache. This case series presents six COVID-19 infected patients with refractory headache, in which intranasal bedside Sphenopalatine Ganglion Block was performed for analgesia. All patients had a reduction in headache intensity from severe pain to mild or no pain after the procedure with minor transient side effects. Proposed mechanisms of action include reduction of local autonomic stimuli, intracranial vasoconstriction, and reduction of vasoactive substances release in the pterygopalatine fossa.

Keywords

Headache,  Sphenopalatine ganglion block,  COVID-19

References

1 V. Montalvan, J. Lee, T. Bueso, et al. Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review Clin Neurol Neurosurg., 194 (2020)

2 KN Arca, AJ Starling Treatment-Refractory Headache in the Setting of COVID-19 Pneumonia: Migraine or Meningoencephalitis? Case Report. SN Compr Clin Med. (2020), pp. 1-4

3 K.W.D. Ho, R. Przkora, S. Kumar Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review J Headache Pain., 18 (2017), p. 118

4 R Tolba, AL Weiss, DJ Denis Sphenopalatine Ganglion Block and Radiofrequency Ablation: Technical Notes and Efficacy Ochsner J., 19 (2019), pp. 32-37

5 M.S. Robbins, C.E. Robertson, E. Kaplan, et al. The Sphenopalatine Ganglion: Anatomy, Pathophysiology, and Therapeutic Targeting in Headache Headache., 56 (2016), pp. 240-258
 

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