Efficacy of Greater Occipital Nerve Block versus Sphenopalatine Ganglion Block for the Treatment of Postdural Puncture Headache after Spinal Anesthesia: A Randomized Clinical Trial.
Urvashi Yadav, Shipra Verma, Deepika Doneria et al.
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In 30 seconds
This randomized clinical trial compared bilateral greater occipital nerve block (GONB) with bilateral sphenopalatine ganglion block (SPGB) in 64 patients with postdural puncture headache after spinal anesthesia. Supine pain scores were significantly lower with GONB at 30 minutes, 1 hour, and 2 hours; sitting scores were lower at 30 minutes, 1 hour, 2 hours, and 6 hours. The treatments had similar effectiveness after 12 hours (P > 0.05). No major adverse effects were observed, and no patient in either group required an epidural blood patch.
Key findings
- Supine NRS scores favored GONB at 30 minutes, 1 hour, and 2 hours (P = 0.029, 0.002, and 0.021, respectively).
- Sitting NRS scores favored GONB at 30 minutes, 1 hour, 2 hours, and 6 hours (P = 0.006, 0.042, 0.009, and 0.012, respectively).
- After 12 hours, headache outcomes were similar between groups (P > 0.05); neither group had major adverse effects or epidural blood patch use.
Why it matters
The comparison suggests that these two minimally invasive blocks may differ in the speed of headache relief, while providing similar benefit later. This distinction may inform clinical discussions about short-term symptom control, alongside the trial’s findings that no major adverse effects or need for epidural blood patch occurred in either group.
What to keep in mind
The trial included 64 patients, and the abstract does not report effect sizes for the between-group pain-score differences, limiting assessment of their clinical magnitude.