Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials
Braz. J. Anesth. (Impr.)
; 73(6): 782-793, Nov.Dec. 2023. tab, graf
Article
in En
| LILACS
| ID: biblio-1520392
Responsible library:
BR891.2
ABSTRACT
Abstract 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.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Post-Dural Puncture Headache
/
Sphenopalatine Ganglion Block
Type of study:
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Braz J Anesthesiol
/
Braz. J. Anesth. (Impr.)
/
Brazilian Journal of Anesthesiology (Impresso)
/
Brazilian journal of anesthesiology (English edition. Online)
Journal subject:
ANESTESIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Country of publication: