THE EFFECT OF SPHENOPALATINE GANGLION BLOCK(SPGB) USING TRANSNASAL TOPICAL BUPIVACAINE FOR THE ACUTE TREATMENT OF CHRONIC MIGRAINE.

The neurovascular disorder migraine is one of the most common diseases worldwide. There are many medical treatment options available for chronic migraine, but these treatment options often found to have significant side effects. Sphenopalatine ganglion is a parasympathetic ganglion composed of sensory and autonomic nerves. This neural structure is located deeply in the pterygopalatine fossa posterior to the middle turbinate and maxillary sinus on each side of the face. Here we study the effect of sphenopalatine ganglion block(SPGB) using transnasal topical bupivacaine for the acute treatment of chronic migraine. It is a double Materials and Methodsblinded randomized controlled study. A study was conducted on 100 patients coming with acute episode of chronic migraine who were randomized in to two groups to receive 0.5% bupivacaine or saline respectively to undergo SPGB. Pre treatment NRS score was documented and post t reatment NRS assessed at 15 mins, 30 mins, 24 hours and at the end of 1 st and 6 th month and compared with the baseline NRS. Results: A total of 100 cases were enrolled in the study. In Bupivacaine group, the mean NRS score decreased significantly from a baseline of 6.7 to 3.8(43.3% reduction) and 3.8(43.3% reduction) at 30 mins and at the end of 6 th month respectively after repeated SPGBs. Conclusion: Transnasal topical sphenopalatine ganglion block is effective in acute treatment of chronic migraine.