Department of Obstetrics and Gynecology, Rinku General Medical Center, Osaka, Japan.
Department of Anesthesiology, Rinku General Medical Center, Osaka, Japan.
J Obstet Gynaecol Res. 2024 Dec;50(12):2357-2361. doi: 10.1111/jog.16121. Epub 2024 Oct 13.
Spinal anesthesia is a widely practiced anesthetic technique during cesarean section but is associated with the risk of postdural puncture headache (PDPH). This article reports a case of refractory PDPH following a cesarean section that achieved immediate pain relief after a sphenopalatine ganglion block (SPGB). SPGB has been proposed as a non-invasive alternative to the traditional epidural blood patch for nonobstetrical PDPH, nonetheless, it is a procedure not commonly performed by obstetricians. By targeting the sphenopalatine ganglion, SPGB offers a viable treatment option for PDPH and provides immediate relief to patients. This case report and literature review suggest that SPGB is a promising, effective, and safe approach for managing PDPH after cesarean section. Considering SPGB as an alternative to epidural blood patch, obstetricians can offer noninvasive treatment options for patients with PDPH.
脊髓麻醉是剖宫产术中广泛应用的麻醉技术，但与硬膜穿刺后头痛（PDPH）的风险相关。本文报告了一例剖宫产术后难治性 PDPH 病例，经蝶腭神经节阻滞（SPGB）后即刻缓解疼痛。SPGB 已被提议作为非产科 PDPH 传统硬膜外血贴的一种非侵入性替代方法，但它不是产科医生通常进行的程序。通过靶向蝶腭神经节，SPGB 为 PDPH 提供了一种可行的治疗选择，并为患者提供即刻缓解。本病例报告和文献复习表明，SPGB 是治疗剖宫产术后 PDPH 的一种有前途、有效和安全的方法。将 SPGB 作为硬膜外血贴的替代方法，产科医生可以为 PDPH 患者提供非侵入性的治疗选择。
