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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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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. |
format | Online Article Text |
id | pubmed-10625157 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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