Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management : a meta-analysis of randomized trials
Copyright © 2023 Sociedade Brasileira de Anestesiologia. Published by Elsevier España S.L.U. All rights reserved..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
|---|---|
| Enthalten in: |
Brazilian journal of anesthesiology (Elsevier) - 73(2023), 6 vom: 06. Nov., Seite 782-793 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dwivedi, Priyanka [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
98PI200987 |
|---|
| Anmerkungen: |
Date Completed 07.11.2023 Date Revised 09.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.bjane.2023.06.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM359232515 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM359232515 | ||
| 003 | DE-627 | ||
| 005 | 20231226080433.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.bjane.2023.06.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1197.xml |
| 035 | |a (DE-627)NLM359232515 | ||
| 035 | |a (NLM)37422191 | ||
| 035 | |a (PII)S0104-0014(23)00063-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dwivedi, Priyanka |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management |b a meta-analysis of randomized trials |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.11.2023 | ||
| 500 | |a Date Revised 09.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Sociedade Brasileira de Anestesiologia. Published by Elsevier España S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a PROSPERO REGISTRATION: CRD42021291707 | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Conservative treatment | |
| 650 | 4 | |a Headache | |
| 650 | 4 | |a Pain management | |
| 650 | 4 | |a Post-dural puncture headache | |
| 650 | 4 | |a Sphenopalatine ganglion block | |
| 650 | 7 | |a Lidocaine |2 NLM | |
| 650 | 7 | |a 98PI200987 |2 NLM | |
| 700 | 1 | |a Singh, Pratibha |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Tejas K |e verfasserin |4 aut | |
| 700 | 1 | |a Bajpai, Vijeta |e verfasserin |4 aut | |
| 700 | 1 | |a Kabi, Ankita |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Yashpal |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Santosh |e verfasserin |4 aut | |
| 700 | 1 | |a Kishore, Surekha |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Brazilian journal of anesthesiology (Elsevier) |d 2013 |g 73(2023), 6 vom: 06. Nov., Seite 782-793 |w (DE-627)NLM225306182 |x 2352-2291 |7 nnns |
| 773 | 1 | 8 | |g volume:73 |g year:2023 |g number:6 |g day:06 |g month:11 |g pages:782-793 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.bjane.2023.06.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 73 |j 2023 |e 6 |b 06 |c 11 |h 782-793 | ||