scholarly journals Verification of Sphenopalatine Ganglion Block Success Using Transcranial Doppler in Management of Patients with Postdural

2021 ◽  
pp. E661-E668
Keyword(s):  
Clinical Trial ◽  
Treatment Group ◽  
Intracranial Pressure ◽  
Transcranial Doppler ◽  
Control Group ◽  
Sphenopalatine Ganglion ◽  
Mean Flow ◽  
Ganglion Block ◽  
Group A ◽  
Sphenopalatine Ganglion Block

BACKGROUND: Sphenopalatine ganglion block (SPGB) is traditionally advised in the management of head and neck pain. Since SPGB is a minimally invasive, repeatable, and simple technique, SPGB should be tried first in the management of postdural puncture headaches (PDPH). Verification of the block’s success in diagnostic, prognostic, and therapeutic nerve blocks, is of paramount importance in pain management. OBJECTIVES: This study intends to prove the ability of SPGB in the management of PDPH. Transcranial Doppler (TCD) is utilized as an objective measure to assess the block’s success by monitoring variations in the cerebral hemodynamics before and after the block procedure. Noninvasive intracranial pressure (nICP) was applied to support the theory which assumes that the vasodilation of the cerebral blood vessels is the precipitating cause of the PDPH, rather than intracranial hypotension. STUDY DESIGN: Prospective, triple blinded, controlled, clinical trial. SETTING: This clinical trial was conducted at Zagazig University. METHODS: In the present study, 123 patients were considered who had spinal and/or epidural anesthesia; 63 patients who developed PDPH joined treatment group A and received the SPGB block. The control group B included 60 patients with no PDPH. The patients in group A were evaluated preprocedure by a numerical pain score and at 30 minutes, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours postprocedure. Furthermore, patients in both groups were evaluated employing TCD before the transnasal block was given, then it was repeated to group A only within one hour after the block. RESULTS: Results analysis revealed that preprocedural pulsatility index (PI) and mean flow velocity (MFV) values in treatment group A were (mean ± standard deviation [SD]) 0.63 ± 0.04 and 57.20 ± 4.85 cm s-1, respectively. Values of PI and MFV were significantly increased up to (mean ± SD) 0.87 ± 0.08 and 71.15 ± 7.686 cm s-1, respectively after the block. The computed nICP values preblock and postblock were also within the normal range. LIMITATIONS: Performing SPGB without standardized equipment may limit the results of the current study CONCLUSIONS: SPGB should be considered as a first treatment modality for PDPH. Moreover, the results indicate that TCD is a successful objective tool in assessing a transnasal sphenopalatine ganglion block. KEY WORDS: Noninvasive intracranial pressure, postdural puncture headache, sphenopalatine ganglion block, transcranial Doppler

scholarly journals Effect of Sphenopalatine Ganglion Block With Bupivacaine on Postoperative Pain in Patients Undergoing Endoscopic Sinus Surgery

2019 ◽  
Vol 10 ◽  
pp. 215265671882128 ◽  
Author(s):  
Ahmad Rezaeian ◽  
Seyed Mostafa Hashemi ◽  
Zeinab Sadat Dokhanchi
Keyword(s):  
Postoperative Pain ◽  
Endoscopic Sinus Surgery ◽  
Intervention Group ◽  
Sinus Surgery ◽  
Control Group ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Rescue Analgesia ◽  
Sphenopalatine Ganglion Block ◽  
And Control

Background Postoperative pain is one of the most complications in endoscopic sinus surgery. We aimed to evaluate the effect of the sphenopalatine ganglion block (SPGB) with bupivacaine on postoperative pain in patients undergoing endoscopic sinus surgery. Methods and Materials: In this clinical trial, 40 patients who indicated functional endoscopic sinus surgery were selected and then divided into 2 parallel groups as intervention and control. The intervention group was received 1.5 mL of bupivacaine 0.5% (injected to sphenopalatine ganglion) and while control was injected 1.5 mL of normal saline at the same injection site. Also, the visual analogue scale (VAS) was recorded immediately after anesthesia, along with 6, 12, 24, 48 h, 7 days, and 21 days after the operation for all patients. Results Immediately after anesthesia, as well as 6, 12, and 24 h after the operation, VAS in the intervention group was significantly lower than in the control group ( P < .05, for all). However, there were no significant differences between the 2 groups regarding VAS 48 h as well as 7 and 21 days after surgery ( P > .05, for both). Also, the rescue analgesia in the intervention group was significantly lower than in the control group ( P = .01). Conclusion SPGB with bupivacaine 0.5% (1.5 mL) was a simple, effective, safe, and noninvasive method for the management of postoperative pain in the patients undergoing endoscopic sinus surgery.

scholarly journals Sphenopalatine ganglion block for the treatment of postdural puncture headache: a randomised, blinded, clinical trial

2020 ◽  
Vol 124 (6) ◽  
pp. 739-747 ◽  
Author(s):  
Mads S. Jespersen ◽  
Pia Jaeger ◽  
Karen L. Ægidius ◽  
Maria L. Fabritius ◽  
Patricia Duch ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sphenopalatine Ganglion ◽  
Postdural Puncture Headache ◽  
Ganglion Block ◽  
Sphenopalatine Ganglion Block

The Effect of Sphenopalatine Ganglion Block on the Postoperative Pain in Patients Undergoing Septorhinoplasty

2020 ◽  
Vol 129 (7) ◽  
pp. 722-726
Author(s):  
Nazan Degirmenci ◽  
Abdullah Ozdem ◽  
Harun Uysal ◽  
Pelin Sen ◽  
Erol Senturk ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Control Group ◽  
Average Dose ◽  
Sphenopalatine Ganglion ◽  
Block Group ◽  
Ganglion Block ◽  
Significant Difference ◽  
Sphenopalatine Ganglion Block ◽  
The Difference

Objectives: This study aimed to evaluate the effect of preoperative sphenopalatine ganglion block (SPBG) on the postoperative pain (POP) in patients undergoing septorhinoplasty (SRP). Methods: A retrospective cohort study was performed. A total of 42 patients that had received septorhinoplasty included in the study. The patients that had received SPBG before the surgery included in the Block group (n:20) and the patients that had not received SPBG before the surgery included in the Control group (n:22). POP was questioned with a numeric rating scale (NRS) at the 30th minute (t1), 1st hour (t2), 4th hour (t3), 12th hour (t4), and 24th hour (t5) and noted. The intraoperative details and the dose of the postoperative rescue analgesics were also noted. Results: The average dose of Paracetamol that was used in the postoperative first 24 hours was 500 mg in the Block group and 1363 mg in the Control group, and the difference was statistically significant ( P = .001). The average dose of Tramadol was 0 mg in the Block group and 45 mg in the Control group, and the difference was statistically significant ( P = .001). There was a statistically significant difference among the groups with respect to NRS in the first 24 hours postoperatively ( P < .05). The number of the patients requiring rescue analgesics was lower in the Block group than the Control group. The difference was statistically significant at the t1, t2, and t5 time intervals ( P > .05). Conclusions: Preoperative SPGB is an effective option to reduce POP and the need for rescue analgesics for patients undergoing SRP. Clinical trial number: NCT04020393

Sphenopalatine ganglion block for the treatment of acute headache: An old treatment revisited

2021 ◽  
Author(s):  
Meredith Busman ◽  
Tiffany Fleeger ◽  
Erin Leach ◽  
Natalie Payne ◽  
Andrew Nguyen ◽  
...  
Keyword(s):  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Sphenopalatine Ganglion Block ◽  
Acute Headache

Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
L.A. Vaira ◽  
C. Hopkins ◽  
M. Petrocelli ◽  
J.R. Lechien ◽  
S. Cutrupi ◽  
...  
Keyword(s):  
Treatment Group ◽  
Case Control Study ◽  
Spontaneous Recovery ◽  
Olfactory Function ◽  
Control Group ◽  
Initial Control ◽  
Group A ◽  
Control Study

BACKGROUND: The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify effective treatments that enhance the spontaneous recovery of olfactory function. METHODS: Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS: In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS: Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.

scholarly journals Expressive arts therapy for hospitalized children: a pilot study measuring cortisol levels

2013 ◽  
Vol 5 (2) ◽  
pp. 7 ◽  
Author(s):  
Garret Yount ◽  
Kenneth Rachlin ◽  
Jane Siegel
Keyword(s):  
Pilot Study ◽  
Treatment Group ◽  
Expressive Arts ◽  
Control Group ◽  
Hospitalized Children ◽  
Expressive Arts Therapy ◽  
Wait List Control Group ◽  
Wait List Control ◽  
Group A ◽  
Cortisol Levels

This pilot study aimed at assessing the feasibility of capturing physiological evidence of reduced stress for hospitalized children following expressive arts therapy. Twenty-five patients were offered a novel form of expressive arts therapy, termed Healing Sock Creatures, during their stay in the hospital. Saliva samples were collected at two times in the afternoon for the purpose of measuring salivary cortisol levels. The patients were randomly assigned to two groups, a treatment group or a wait-list control group. A trend of decreased cortisol levels was apparent following therapy in the treatment group and concurrent steroid treatment, which is common in intensive care units, does not appear to interfere with the ability to measure decreased cortisol levels following therapy. Our results support the design of a formal study to assess physiological biomarkers of stress in hospital settings. To our knowledge, this is the first in-patient study assessing a biomarker of stress following expressive arts therapy for children

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