Comparative Study between Transnasal Sphenopalatine Ganglion Block versus Nebulized Dexmedetomidine for Treatment of Postdural Puncture Headache after Inguinal Hernia Repair: A Randomized Controlled Trial

Allam, Tamer M.; Saleh, Ramy Mousa; Elnady, Mahmoud M.

doi:10.21608/svuijm.2025.334247.2014

Comparative Study between Transnasal Sphenopalatine Ganglion Block versus Nebulized Dexmedetomidine for Treatment of Postdural Puncture Headache after Inguinal Hernia Repair: A Randomized Controlled Trial

Document Type : Original research articles

Authors

Anesthesia and Surgical ICU Department, Faculty of Medicine, Benha University, Benha 13511, Egypt.

10.21608/svuijm.2025.334247.2014

Abstract

Background: In ambulatory surgery, repair of inguinal hernia is one of the most frequently performed surgical operations. Post-dural puncture headache (PDPH) is a condition that is frequently associated with inadvertent dural puncture and neuraxial anaesthesia.
Objectives: This trial objective was to estimate the efficacy of trans-nasal the sphenopalatine ganglion block (SPGB) compared to nebulized dexmedetomidine (DEX) in the treatment of PDPH.
Patients and methods: This prospective, double-blinded, randomized controlled trial was done on 96 adult patients diagnosed to have PDPH after unilateral inguinal hernia repair. Patients having a visual analogue scale (VAS) score of ≥ 4 were enrolled and allocated into 2 equal groups randomly, group one received trans-nasal SPGB 4% lignocaine and group II received nebulized DEX. Standard intraoperative monitoring was done for blood pressure, electrocardiography, respiratory rate, heart rate, arterial oxygen saturation, and capnography.
Results: VAS at 12, 18, 24 and 36h was markedly lower in group one in comparison to group two (P<0.05), whereas at baseline, 15 min, 30 min, 1h and 6h was insignificantly different between both groups. The number of patients that needed rescue analgesia postoperatively at 12, 18, 24 and 36h was markedly lower in group one in comparison to group two (P<0.05), whereas at baseline, 15 min, 30 min, 1h and 6h was insignificantly varying between both groups.
Conclusion: Trans-nasal SPGB was helpful in post-dural puncture headache treatment after inguinal hernia repair, as evidenced by lower pain levels, less postoperative rescue analgesia, and a greater satisfaction rate in comparison to nebulized DEX.

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