التفاصيل البيبلوغرافية
| العنوان: |
Pterygopalatine Fossa Blockade as Novel, Narcotic-Sparing Treatment for Headache in Patients with Spontaneous Subarachnoid Hemorrhage. |
| المؤلفون: |
Smith, Cameron R.1 (AUTHOR), Fox, W. Christopher2 (AUTHOR), Robinson, Christopher P.2,3 (AUTHOR), Garvan, Cynthia1 (AUTHOR), Babi, Marc-Alain2,3 (AUTHOR), Pizzi, Michael A.2,3 (AUTHOR), Lobmeyer, Erica1 (AUTHOR), Bursian, Alberto1 (AUTHOR), Maciel, Carolina B.2,3 (AUTHOR), Busl, Katharina M.2,3 (AUTHOR) k.busl@ufl.edu |
| المصدر: |
Neurocritical Care. Aug2021, Vol. 35 Issue 1, p241-248. 8p. |
| مصطلحات موضوعية: |
*SUBARACHNOID hemorrhage, *CEREBRAL vasospasm, *HEADACHE, *ADULTS, *ANALGESIA |
| مستخلص: |
Background: Severe headache is a hallmark clinical feature of spontaneous subarachnoid hemorrhage (SAH), affecting nearly 90% of patients during index hospitalization, regardless of the SAH severity or presence of a culprit aneurysm. Up to 1 in 4 survivors of SAH experience chronic headaches, which may be severe and last for years. Data guiding the optimal management of post-SAH headache are lacking. Opioids, often in escalating doses, remain the guideline-recommended mainstay of acute therapy, but pain relief remains suboptimal. Methods: This study is a case series of adult patients who received bilateral pterygopalatine fossa (PPF) blockade for the management of refractory headaches after spontaneous SAH (aneurysmal and non-aneurysmal) at a single tertiary care center. We examined pain scores and analgesic requirements before and after block placement. Results: Seven patients (median age 54 years, 3 men, four aneurysmal and three non-aneurysmal) received a PPF-block between post-bleed day 6–11 during index hospitalization in the neurointensive care unit. The worst pain recorded in the 24-h period before the block was significantly higher than in the period 4 h after the block (9.1 vs. 3.1; p = 0.0156), and in the period 8 h after the block (9.1 vs. 2.8; p = 0.0313). The only complication was minor oozing from the needle insertion sites, which subsided completely with gauze pressure within 1 min. Conclusions: PPF blockade might constitute a promising opioid-sparing therapeutic strategy for the management of post-SAH headache that merits further prospective controlled randomized studies. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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