Case Series on the Efficacy of Sphenopalatine Ganglion Block Using a 20G Intravenous Cannula for Postdural Puncture Headache after Cesarean Section: A Novel Approach and Feasibility for Home Use in Migraine Patients

Background: Postdural puncture headache (PDPH) is a common complication following neuraxial anesthesia, particularly in obstetric patients. Conventional treatments like epidural blood patches may not always be effective or feasible. Aims and Objectives: To evaluate the efficacy of a novel sphenopalatine ganglion (SPG) block technique using a 20G intravenous (IV) cannula in relieving PDPH after cesarean section and to explore its feasibility for home-based use in migraine patients. Materials and Methods: A case series of five female patients who developed PDPH following cesarean section was conducted. Each patient received bilateral SPG block with 1 mL of 4% lignocaine via 20G IV cannula inserted through the nostrils. Pain scores were assessed using the Numerical Rating Scale (NRS) before and at multiple time points after the procedure. Follow-up included monitoring for duration of pain relief and side effects. Results: All patients experienced a significant reduction in NRS scores post-SPG block. Pain relief lasted between 6–12 hours, and only one patient required a repeat block. No serious adverse events were reported. One patient with tinnitus noted complete resolution of symptoms following the block. Minor side effects included transient nasal irritation and metallic taste. Conclusion: SPG block using a 20G IV cannula is an effective and well-tolerated treatment for PDPH, offering rapid pain relief and minimal side effects. Its simplicity and comfort also suggest potential for safe home use in managing migraine headaches.