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Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials

OBJECTIVE: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management. METHODS: A systematic literature search was conducted on databases for Randomized Controlled Trials (RCTs) comparing trans-nasal...

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Autores principales: Dwivedi, Priyanka, Singh, Pratibha, Patel, Tejas K., Bajpai, Vijeta, Kabi, Ankita, Singh, Yashpal, Sharma, Santosh, Kishore, Surekha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625157/
https://www.ncbi.nlm.nih.gov/pubmed/37422191
http://dx.doi.org/10.1016/j.bjane.2023.06.002
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author Dwivedi, Priyanka
Singh, Pratibha
Patel, Tejas K.
Bajpai, Vijeta
Kabi, Ankita
Singh, Yashpal
Sharma, Santosh
Kishore, Surekha
author_facet Dwivedi, Priyanka
Singh, Pratibha
Patel, Tejas K.
Bajpai, Vijeta
Kabi, Ankita
Singh, Yashpal
Sharma, Santosh
Kishore, Surekha
author_sort Dwivedi, Priyanka
collection PubMed
description OBJECTIVE: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management. METHODS: A systematic literature search was conducted on databases for Randomized Controlled Trials (RCTs) comparing trans-nasal SPG blockade for the management of PDPH over other treatment modalities. All outcomes were pooled using the Mantel-Haenszel method and random effect model. Analyses of all outcomes were performed as a subgroup based on the type of control interventions (conservative, intranasal lignocaine puffs, sham, and Greater Occipital Nerve [GON] block). The quality of evidence was assessed using the GRADE approach. RESULTS: After screening 1748 relevant articles, 9 RCTs comparing SPG block with other interventions (6 conservative treatments, 1 sham, 1 GON and 1 intranasal lidocaine puff) were included in this meta-analysis. SPG block demonstrated superiority over conservative treatment in pain reduction at 30 min, 1 h, 2 h, 4 h after interventions and treatment failures with “very low” to “moderate” quality of evidence. The SPG block failed to demonstrate superiority over conservative treatment in pain reduction beyond 6 h, need for rescue treatment, and adverse events. SPG block demonstrated superiority over intranasal lignocaine puff in pain reduction at 30 min, 1 h, 6 h, and 24 h after interventions. SPG block did not show superiority or equivalence in all efficacy and safety outcomes as compared to sham and GON block. CONCLUSION: Very Low to moderate quality evidence suggests the superiority of SPG block over conservative treatment and lignocaine puff for short-term pain relief from PDPH. PROSPERO REGISTRATION: CRD42021291707.
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spelling pubmed-106251572023-11-05 Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials Dwivedi, Priyanka Singh, Pratibha Patel, Tejas K. Bajpai, Vijeta Kabi, Ankita Singh, Yashpal Sharma, Santosh Kishore, Surekha Braz J Anesthesiol Review Article OBJECTIVE: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management. METHODS: A systematic literature search was conducted on databases for Randomized Controlled Trials (RCTs) comparing trans-nasal SPG blockade for the management of PDPH over other treatment modalities. All outcomes were pooled using the Mantel-Haenszel method and random effect model. Analyses of all outcomes were performed as a subgroup based on the type of control interventions (conservative, intranasal lignocaine puffs, sham, and Greater Occipital Nerve [GON] block). The quality of evidence was assessed using the GRADE approach. RESULTS: After screening 1748 relevant articles, 9 RCTs comparing SPG block with other interventions (6 conservative treatments, 1 sham, 1 GON and 1 intranasal lidocaine puff) were included in this meta-analysis. SPG block demonstrated superiority over conservative treatment in pain reduction at 30 min, 1 h, 2 h, 4 h after interventions and treatment failures with “very low” to “moderate” quality of evidence. The SPG block failed to demonstrate superiority over conservative treatment in pain reduction beyond 6 h, need for rescue treatment, and adverse events. SPG block demonstrated superiority over intranasal lignocaine puff in pain reduction at 30 min, 1 h, 6 h, and 24 h after interventions. SPG block did not show superiority or equivalence in all efficacy and safety outcomes as compared to sham and GON block. CONCLUSION: Very Low to moderate quality evidence suggests the superiority of SPG block over conservative treatment and lignocaine puff for short-term pain relief from PDPH. PROSPERO REGISTRATION: CRD42021291707. Elsevier 2023-07-06 /pmc/articles/PMC10625157/ /pubmed/37422191 http://dx.doi.org/10.1016/j.bjane.2023.06.002 Text en © 2023 Sociedade Brasileira de Anestesiologia. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Dwivedi, Priyanka
Singh, Pratibha
Patel, Tejas K.
Bajpai, Vijeta
Kabi, Ankita
Singh, Yashpal
Sharma, Santosh
Kishore, Surekha
Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title_full Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title_fullStr Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title_full_unstemmed Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title_short Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
title_sort trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625157/
https://www.ncbi.nlm.nih.gov/pubmed/37422191
http://dx.doi.org/10.1016/j.bjane.2023.06.002
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