THE MOST EFFECTIVE METHOD OF UTILIZING SPHENOPALATINE GANGLION BLOCKS IS SEL-ADMINISTRATION WITH COTTON TIPPED CATHETER TO PREVENT THE NEED FOR HOSPITAL VISITS. tHIS IS AN ARTICLE WITH THREE CASE REPORTS AFTER PATIENTS REACH THE HOSPITAL. eARLY INTERVENTION IS PREFERABLE.
New article 2022 on use of SPG Blocks for severe headache in ER. Abstract
Headaches are a common presenting complaint to the emergency department. Amongst the common non-life-threatening headaches, migraine headaches tend to be one of the more severe. Commonly, migraines are treated with the so-called “migraine cocktail.” At our facility, this cocktail is usually IV fluids, metoclopramide, diphenhydramine, and ketorolac. The patient is then left in a quiet, dark room for two to three hours, then reassessed for symptom improvement or if more medications are required. Recently we have begun to employ the sphenopalatine ganglion (SPG) block as a rapid, and easy-to-administer alternative to the classic migraine cocktail. The SPG block can often provide sufficient improvement of symptoms within 15 minutes to allow the patient to be discharged. Patients are grateful to have such rapid pain relief, and the ED flow is improved with a door-to-discharge time that can be less than an hour. The following is a series of three recent cases where we have used the SPG block to treat migraines in our ED patients.