Date of Award

Spring 5-4-2018

Document Type

DNP Project

Project Team Faculty Member

Dr. Andrew Griffin

Project Team Faculty Member

Dr. Mary Zerlan

Keywords

sphenopalatine ganglion block, post-dural puncture headache, SphenoCath

Abstract

Post-dural puncture headache (PDPH) is defined as an orthostatic, fronto-occipital headache. The incidence of PDPH from neuraxial anesthesia techniques averages 1%. There are several treatments for PDPHs. The gold standard is the epidural blood patch (EBP). The EBP can be costly, requires experience, and is associated with rare, but serious complications. These factors present significant barriers to treating PDPHs. The sphenopalatine ganglion (SPG) block consists of using local anesthetics to block the parasympathetic signals, which flow through the SPG. Current theories suggest that increased parasympathetic outflow is the trigger for many forms of headaches, including PDPHs. Various literature associated with SPG blocks and PDPH treatments were synthesized using the Iowa Model for Evidence-Based Practice into a SPG block protocol for a central Illinois community hospital. The protocol was implemented from 05/08/2017 to 10/27/2017 after a presentation and hands on training conducted by the author, the facility stakeholder, and the SphenoCath representative. Evaluation of the protocol and the presentation was via survey. Survey results revealed, one provider implemented the protocol on three patients. Anecdotal data demonstrated all three patients experienced relief and required no further treatment. The protocol provided a less invasive, effective option for treating PDPHs.

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