Olsen Kevin R, Cometa M Anthony, Zasimovich Yury
Department of Anaesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Turk J Anaesthesiol Reanim. 2020 Dec;48(6):502-504. doi: 10.5152/TJAR.2020.06887. Epub 2020 May 18.
Placement of an epidural blood patch is the gold standard treatment for a postdural puncture headache when conservative measures have failed. If unsuccessful in relieving the symptoms, a second epidural blood patch may be warranted. However, when the accepted gold standard treatment has failed, alternative therapies may be pursued. A pterygopalatine ganglion block has been shown to be effective as an alternative to epidural blood patch placement. This case demonstrates the use of a suprazygomatic pterygopalatine ganglion block as a rescue technique for failed repeated epidural blood patch, with complete and permanent resolution of the headache.
当保守治疗措施失败时，硬膜外血贴是治疗硬膜穿刺后头痛的金标准疗法。若未能缓解症状，可能需要进行第二次硬膜外血贴。然而，当公认的金标准治疗失败时，可以采用替代疗法。翼腭神经节阻滞已被证明是替代硬膜外血贴的有效方法。本病例展示了使用颧上翼腭神经节阻滞作为反复硬膜外血贴失败后的挽救技术，头痛得以完全且永久缓解。
