CClinicalTrials.gg
TerminatedNCT03430531Updated Jun 15, 2022Results posted

Effectiveness of Sphenopalatine Ganglion Block for Post-Dural Puncture Headache

A Phase 2 interventional study of Lidocaine in Post-Dural Puncture Headache and Sphenopalatine Ganglion Block, sponsored by Milton S. Hershey Medical Center. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-06-15.

Sponsored by Milton S. Hershey Medical Center · Phase 2, Interventional, and Treatment

Why this study was terminated
Study suspended and subsequently terminated due to Pandemic
Phase
Phase 2
Study type
Interventional
Enrollment
6
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The objective of the study is to determine the effectiveness of Spheno-Palatine (SP) ganglion block to alleviate the pain of post-dural puncture headache (PDPH).

Read the detailed description

The primary objectives of the study are to study the effectiveness of SP ganglion block in relieving post-dural puncture headache in terms of :

  1. Number of subjects who get relief of pain
  2. The onset time to pain relief after application of block
  3. The duration of pain relief
  4. The incidence of recurrence of post-dural puncture headache

Secondary objectives are to:

  1. Monitor any complications due to SP ganglion block
  2. Measure patient satisfaction
  3. Monitor any residual effects at 1 months after the SP block
02

Conditions studied

  • Post-Dural Puncture Headache
  • Sphenopalatine Ganglion Block
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Complains of symptoms suggestive of post-dural puncture headache
  2. Has a history of dural puncture (lumbar puncture or accidental dural puncture during epidural placement) within the previous 7 days
  3. Fluent in written and spoken English

Exclusion criteria

Exclusion Criteria:

  1. Those with a known history of hypersensitivity to local anesthetics of the amide type or to other components of GLYDO
  2. Those with any congenital or acquired, anatomical deformity of the nostril, which preclude performing the block
  3. Those who refuse to consent to participate in the study
  4. Patients who have had a failed epidural blood patch
  5. Cognitive Impairment
  6. Prisoner
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
6 participants (actual)

Study arms

  • Experimental
    Sphenopalatine ganglion block

    Sphenopalatine ganglion block: this block will be performed by inserting swabs, with lidocaine squirted on them, into each nostril and reaching the nasopharyngeal wall.

    Drug: Lidocaine

Interventions

  • DrugLidocaine

    Lidocaine 2% viscous (0.5ml) will be squirted on two cotton swab sticks and one will be gently inserted into each nostril, along the floor of the nose. Slight rotatory motion of the stick will be used to insert it as far as it goes with the intention to reach the nasopharyngeal wall (posterior wall of the nose). At that position the swab sticks will be left undisturbed for 5 minutes. The swabs will be taken out and this will be repeated twice more, using fresh swabs and 0.5ml of 2% lidocaine. The block would take about 30 minutes.

05

What researchers measure

Primary outcomes

  1. Pain Score at Baseline

    Pain scores will be recorded at Baseline in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 15 minutes before the SP block

  2. Pain Score 60 Minutes Post-SP Block

    Pain scores will be recorded 60 minutes post-SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 60 minutes

  3. Pain Score 1 Day Post-SP Block

    Patient reported pain scores will be recorded day 1 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 1 day

  4. Pain Score 2 Days Post-SP Block

    Patient reported pain scores will be recorded day 2 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 2 days

  5. Pain Score 7 Days Post-SP Block

    Patient reported pain scores will be recorded day 7 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 7 days

  6. Pain Score 30 Day Post-SP Block

    Patient reported pain scores will be recorded day 30 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

    Time frame: 30 days

Secondary outcomes

  1. Duration of Pain Relief

    Patient reported how long after the SP block the patient reported pain scores that were decreased form the baseline measures. The outcome measure is measured in hours that pain relief was achieved.

    Time frame: 24 hours

  2. Number of Participants With Recurrence of Post-dural Puncture Headache

    Patient reported recurrence of post dural puncture headache resulting in treatment with epidural blood patch

    Time frame: 7 days

  3. Number of Participants With Complications Due to SP Ganglion Block

    Patients will be asked to report any side effects, including: allergic reaction to lidocaine, nose irritation and nose-bleed.

    Time frame: 15 minutes before the SP block to 30 days post SP block

06

Results

Posted Jun 15, 2022
Limitations and caveats
The target enrollment was not reached secondary to the COVID-19 pandemic.

Participant flow

Participant flow — Overall Study
MilestoneSphenopalatine Ganglion Block
Started6
Completed6
Not completed0

Outcome measures

PrimaryPain Score at Baseline

Pain scores will be recorded at Baseline in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
15 minutes before the SP block
Reported as:
Mean · units on a scale
Pain Score at Baseline
units on a scaleSphenopalatine Ganglion Block
Pain Score at Baseline9.33 ± 0.82
PrimaryPain Score 60 Minutes Post-SP Block

Pain scores will be recorded 60 minutes post-SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
60 minutes
Reported as:
Mean · units on a scale
Pain Score 60 Minutes Post-SP Block
units on a scaleSphenopalatine Ganglion Block
Pain Score 60 Minutes Post-SP Block0.33 ± 0.82
PrimaryPain Score 1 Day Post-SP Block

Patient reported pain scores will be recorded day 1 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
1 day
Reported as:
Mean · units on a scale
Pain Score 1 Day Post-SP Block
units on a scaleSphenopalatine Ganglion Block
Pain Score 1 Day Post-SP Block5.33 ± 3.50
PrimaryPain Score 2 Days Post-SP Block

Patient reported pain scores will be recorded day 2 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
2 days
Reported as:
Mean · units on a scale
Pain Score 2 Days Post-SP Block
units on a scaleSphenopalatine Ganglion Block
Pain Score 2 Days Post-SP Block3.67 ± 2.66
PrimaryPain Score 7 Days Post-SP Block

Patient reported pain scores will be recorded day 7 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
7 days
Reported as:
Mean · units on a scale
Pain Score 7 Days Post-SP Block
units on a scaleSphenopalatine Ganglion Block
Pain Score 7 Days Post-SP Block2.33 ± 1.97
PrimaryPain Score 30 Day Post-SP Block

Patient reported pain scores will be recorded day 30 post SP block in a sitting position. Pain scores will be quantified using the Visual analog pain (VAS) scale. The visual analog scale (VAS) is a tool widely used to measure pain. The scale range is 0-10 with 0 being no pain and 10 being severe pain.

Time frame:
30 days
Reported as:
Mean · units on a scale
Pain Score 30 Day Post-SP Block
units on a scaleSphenopalatine Ganglion Block
Pain Score 30 Day Post-SP Block1.67 ± 1.37
SecondaryDuration of Pain Relief

Patient reported how long after the SP block the patient reported pain scores that were decreased form the baseline measures. The outcome measure is measured in hours that pain relief was achieved.

Time frame:
24 hours
Reported as:
Mean · hours
Duration of Pain Relief
hoursSphenopalatine Ganglion Block
Duration of Pain Relief13.50 ± 4.43
SecondaryNumber of Participants With Recurrence of Post-dural Puncture Headache

Patient reported recurrence of post dural puncture headache resulting in treatment with epidural blood patch

Time frame:
7 days
Reported as:
Count of participants · Participants
Number of Participants With Recurrence of Post-dural Puncture Headache
ParticipantsSphenopalatine Ganglion Block
Number of Participants With Recurrence of Post-dural Puncture Headache4
SecondaryNumber of Participants With Complications Due to SP Ganglion Block

Patients will be asked to report any side effects, including: allergic reaction to lidocaine, nose irritation and nose-bleed.

Time frame:
15 minutes before the SP block to 30 days post SP block
Reported as:
Count of participants · Participants
Number of Participants With Complications Due to SP Ganglion Block
ParticipantsSphenopalatine Ganglion Block
Number of Participants With Complications Due to SP Ganglion Block0

Adverse events

Collected over Subjects were monitored for any adverse events for 30 days post-SP block.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Sphenopalatine Ganglion Block0/6 (0%)0/6 (0%)0/6 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Sphenopalatine Ganglion Block
<=18 years0
Between 18 and 65 years6
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Sphenopalatine Ganglion Block
Female5
Male1
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Sphenopalatine Ganglion Block
Hispanic or Latino1
Not Hispanic or Latino5
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Sphenopalatine Ganglion Block
United States6
07

Study locations

1 site
  • Milton S. Hershey Medical Center
    Hershey, Pennsylvania 17033, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Oct 25, 2021
  • Informed consent form · Oct 25, 2021

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03430531
Lead sponsor
Milton S. Hershey Medical Center
Responsible party
Verghese T Cherian, MD (Associate Professor of Anesthesiology & Perioperative Medicine, Milton S. Hershey Medical Center) — Principal investigator
First posted
Feb 13, 2018
Start date
May 31, 2019
Primary completion
Jan 16, 2020
Completion
Mar 11, 2022
Results posted
Jun 15, 2022
Last update
Jun 15, 2022

Study contacts

Verghese Cherian, MD
principal investigator · Milton S. Hershey Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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