Kassim Zawiah, Kamar Rusnaini Mustapha, Zakariah Mohd Fahmi, Chui Geok Ivy Sim
Department of Anaesthesiology and Critical Care, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
J Taibah Univ Med Sci. 2022 Feb 25;17(5):805-809. doi: 10.1016/j.jtumed.2022.02.008. eCollection 2022 Oct.
Postdural puncture headache (PDPH) is a common complication among obstetric patients after neuraxial anaesthesia. Conservative management may be associated with compliance issues, whereas the gold standard treatment, the epidural blood patch, is invasive and can result in serious complications. Transnasal sphenopalatine ganglion (SPG) block has recently emerged as a non-invasive treatment modality for PDPH. We describe our experience in performing transnasal SPG block by using modified techniques and different drug regimens at our centre. Dexamethasone was used as an adjuvant in transnasal SPG block for PDPH and has not been reported in other studies. Our first patient showed complete resolution of PDPH, and our second patient had a partially resolved headache subsequently requiring an epidural blood patch.
硬膜穿刺后头痛（PDPH）是产科患者在接受椎管内麻醉后常见的并发症。保守治疗可能存在依从性问题，而作为金标准治疗方法的硬膜外血贴具有侵入性，且可能导致严重并发症。经鼻蝶腭神经节（SPG）阻滞最近已成为一种用于治疗PDPH的非侵入性治疗方式。我们描述了在我们中心使用改良技术和不同药物方案进行经鼻SPG阻滞的经验。地塞米松在经鼻SPG阻滞治疗PDPH中用作辅助药物，其他研究中尚未有相关报道。我们的首例患者PDPH完全缓解，第二例患者头痛部分缓解，随后需要进行硬膜外血贴治疗。
