Ultrasound-Guided Suprazygomatic Sphenopalatine Ganglion Block for Postdural Puncture Headache Resistant to Epidural Blood Patch: A Case Report

Mahmoud M Alseoudy; Wael A Abd-Elmoaty; Eiad A Ramzy; Ibrahim Abdelbaser; El-Sayed M El-Emam

doi:10.1213/XAA.0000000000001778

Ultrasound-Guided Suprazygomatic Sphenopalatine Ganglion Block for Postdural Puncture Headache Resistant to Epidural Blood Patch: A Case Report

A A Pract. 2024 Apr 4;18(4):e01778. doi: 10.1213/XAA.0000000000001778. eCollection 2024 Apr 1.

Authors

Mahmoud M Alseoudy¹, Wael A Abd-Elmoaty², Eiad A Ramzy¹, Ibrahim Abdelbaser¹, El-Sayed M El-Emam¹

Affiliations

¹ From the Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
² Department of Anesthesia, Sherbeen General Hospital, Ministry of Health, Sherbeen, Egypt.

PMID: 38572887
DOI: 10.1213/XAA.0000000000001778

Abstract

Even though epidural blood patch (EBP) is thought to be the definitive treatment for severe cases of postdural puncture headache (PDPH), it may be accompanied by complications like adhesion arachnoiditis, and cauda equina syndrome, especially if the injection is repeated. The sphenopalatine ganglion (SPG) block is a new minimally invasive technique for the treatment of PDPH, with variable results according to the clinical situation and deployed approach. We describe a case of PDPH resistant to EBP in which we successfully managed symptoms using ultrasound-guided suprazygomatic SPG block to deliver local anesthetic directly into pterygopalatine fossa, thus avoiding a second EBP.

Publication types

Case Reports

MeSH terms

Anesthetics, Local
Blood Patch, Epidural / methods
Humans
Post-Dural Puncture Headache* / etiology
Post-Dural Puncture Headache* / therapy
Sphenopalatine Ganglion Block* / methods
Ultrasonography, Interventional / adverse effects

Substances

Anesthetics, Local