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Background: Postdural puncture headache (PDPH), which is one of the complications of spinal anesthesia, is a condition that negatively affects the quality of life of patients, causes late mobilization and prolonged hospital stay. Sphenopalatine ganglion block (SGB) has created a minimally invasive, easy, and safe treatment alternative.
Objective: Evaluating the effectiveness of topical SGB on PDPH treatment. Design: Retrospective observational study Setting: Single center tertiary level of care hospital study. The files of PDPH patients between Jan 2018 and Jan 2020 were scanned.
Patients: PDPH patients aged 18-65 are included and any patients with primary/secondary headache history are excluded.
Main outcome measures: Patients were divided into 2 groups. The group that given only conservative treatment was named as Group C, and the group of patients who had additionally been applied SGB was named as Group SGB. Headache severity was measured with Visual Analogue Scale (VAS) at the 1st,3rd, 12th and 24th hours of the treatment, in supine and upright position.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group C | Postdural puncture headache patients treated with Conservative treatment |
| |
| Group SGB | Postdural puncture headache patients treated with Sphenopalatine Ganglion Block and conservative treatment |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conservative Treatment for Postdural Puncture Headache | Other | The patients in Group C were given continuous bed rest in the supine position, 3000 mL daily hydration, 6 mg kg-1 aminophylline , 2 g day-1 paracetamol and 65 mg day-1 caffeine as conservative treatment. Topical SGB was applied to patients in Group SGB in addition to conservative treatment. |
| Measure | Description | Time Frame |
|---|---|---|
| Headache in Supine Position | Headache severity changes with Visual Analogue Scale (VAS, 0-10, 0: no pain, 10:worst pain) | 1st, 3rd, 12th and 24th hours of follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Headache in Prone Position | Headache severity changes with Visual Analogue Scale (VAS, 0-10, 0: no pain, 10:worst pain) | 1st, 3rd, 12th and 24th hours of follow-up |
| Successfully treated patients ratio |
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Inclusion Criteria:
Exclusion Criteria:
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Postdural Puncture Headache patients
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| Name | Affiliation | Role |
|---|---|---|
| Burak Kaya, MD | Sakarya University | Principal Investigator |
| Serbülent Gökhan Beyaz, Prof MD | Istinye University | Study Chair |
| Ayça Taş Tuna, As Prof MD | Sakarya University | Study Chair |
| Havva KocayiÄŸit, MD | Sakarya University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sakarya University Training and Research Hospital | Sakarya | 54290 | Turkey (Türkiye) |
Database
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| ID | Term |
|---|---|
| D051299 | Post-Dural Puncture Headache |
| ID | Term |
|---|---|
| D051271 | Headache Disorders, Secondary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D000072700 | Conservative Treatment |
| D059387 | Sphenopalatine Ganglion Block |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D001340 | Autonomic Nerve Block |
| D009407 | Nerve Block |
| D000765 | Anesthesia, Conduction |
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At the 24th hour of their follow-up, all patients with a VAS>3 (Visual Analogue Scale) headache in an upright position are considered as unsuccessful treatment and are directed to the epidural blood patch procedure. Both groups will be compared with successfully treated patients ratios.
| 24th hour of follow-up |
| D009422 | Nervous System Diseases |
| D000758 |
| Anesthesia |
| D000760 | Anesthesia and Analgesia |
| D003714 | Denervation |
| D019635 | Neurosurgical Procedures |
| D013514 | Surgical Procedures, Operative |