Pterygopalatine Fossa Block in Aneurysmal Subarachnoid Hemorrhage

Pterygopalatine Fossa Block in Aneurysmal Subarachnoid Hemorrhage

Aneurysmal subarachnoid hemorrhage (aSAH) can cause a severe headache (HA) that is famously treatment-resistant. Current pain regimens are too reliant on opioids, which results in long-term opioid dependence and can obfuscate the neurological examination, which is critical to detect vasospasm and delayed cerebral ischemia. This study will gather the initial evidence of whether the pterygopalatine fossa (PPF) regional anesthesia nerve block can treat aSAH-related HA and reduce opioid consumption in patients with aSAH.

Inclusion Criteria:

• Aneurysmal subarachnoid hemorrhage with secured aneurysm
• Age greater than or equal to 18 years
• Able to communicate pain level

Exclusion Criteria:

• Documented allergy to local anesthetics (e.g. bupivicaine)
• Patients with unsecured aneurysms
• Patients who are unable to communicate pain level (e.g. sedation/mechanical ventilation/delirium, etc)
• Medical treatment for vasospasm including blood pressure/inotropic augmentation
• Angiographic treatment for vasospasm within 48 hours