An interventional study of Sphenopalatine Ganglion Block using 2% lidocaine in Subarachnoid Hemorrhage in Adult Patients, sponsored by University Hospital, Grenoble. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-03-28.
Sponsored by University Hospital, Grenoble · Not applicable, Interventional, and Treatment
Non-traumatic SAH, linked in 85% of cases to the rupture of an intracranial aneurysm, is a serious stroke affecting young people. Half of all survivors suffer cognitive impairment. The presentation is that of a sudden-onset, isolated headache. This population is exposed to headache during hospitalization, which lasts an average of 13 days. This length of hospitalization is due to the fact that these patients must be monitored during the potential vasospasm period that occurs between days 4 and 14 after SAH. The pain associated with SAH is a source of discomfort and increased morphine consumption during the ICU stay, particularly during the first 10 days. Current recommendations call for conventional pain management with a combination of tier 1, 2 and/or 3 analgesics. For headache control, opioids are widely prescribed, sometimes in high doses, with adverse effects, despite efforts to reduce their use. Maximum headache pain scores remain high, indicating inadequate pain management. This highlights the urgent need to study alternative opioid-sparing and analgesia strategies for patients with SAH.
Sphenopalatine block is already used for certain types of facial and cranial pain, and could help save morphine consumption during hospitalization. The sphenopalatine ganglion is a crossroads for parasympathetic, sympathetic and sensory pathways. Recently studied in post-puncture dural breaches with promising results, sphenopalatine ganglion block (SPGN) may appear as an interesting alternative therapy in the treatment of SAH headaches. Other advantages of this block are its simplicity, efficacy and the absence of any noticeable adverse effects at the time it is performed. What's more, it is already used routinely in our department, with rapid and effective action. The hypothesis of the trial would be to reduce morphine consumption by at least 50% for patients benefiting from BGSP, for better neurological monitoring and optimal overall pain management in SAH.
509 studies on the registry are indexed under Subarachnoid Hemorrhage; 124 are open to participants now.
This study's planned enrollment of 70 is above the median of 52 across 263 interventional studies indexed under Subarachnoid Hemorrhage.
Browse Subarachnoid Hemorrhage studies →University Hospital, Grenoble is the lead sponsor of 815 studies on the registry; 205 are open to participants now.
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Exclusion Criteria:
Pain management according to the protocol in force in the neurosurgical intensive care unit (analgesics: Paracetamol, Nefopam and morphine PCA).
Addition of (BGSP) Sphenopalatine ganglion block with Lidocaine 2% Injectable Solution (2mg/ml) 1.5ml \* 3 consecutive times maximum if EN \>3/10, to be repeated every 12h for 7 days if necessary. BGSP performed by the department's Ides after training by the anesthetists.
A hollow-stem swab soaked in viscous Xylocaine is inserted into the patient's nasal cavity (one swab per nostril) until it stops. 1.5ml Lidocaine 20% (20mg/ml) is injected into each swab using a 5ml syringe and a pink trocar. Both swabs are left in place for 10 min.
Demonstrate a 50% change in morphine consumption with sphenopalatine ganglion block during the first 72 hours after cerebral arteriography
Total morphine consumption in mg in the first 72 hours after cerebral arteriography in the Intensive care (ICU)
Time frame: during 72 hours
Demonstrate a significant 3-point change in pain on EN (Simple Numerical Scale)averaged over 7 days after arteriography
EN (Simple Numerical Scale) 7-day average
Time frame: during 7 days
Describe morphine consumption per day during the patient's hospitalization for the 2 groups
Morphine consumption in mg per day during hospitalization.
Time frame: during hospitalization or 10 days
Describe the complications associated with sphenopalatine ganglion block.
Complications of the sphenopalatine ganglion block technique: incidence of soft palate anesthesia (false liquid routes at H+2), epistaxis, vasovagal reactions, transient hearing loss
Time frame: during 7 days
Evaluate the feasibility of the (BGSP) sphenopalatine ganglion block act performed by Ides
Number of sphenopalatine ganglion block (BGSP) failures
Time frame: during 7 days
Demonstrate that the sphenopalatine ganglion block strategy changes headaches at 28 days.
EN (Simple Numerical Scale) at Day 28, consumption of stage 3 analgesics or neuropathic
Time frame: at 28 days
Demonstrate that the sphenopalatine ganglion block strategy changes patient satisfaction at Day 28
Questionnaire on overall satisfaction with pain management
Time frame: at 28 days
Evaluation of nursing practices on the BGSP technique
Satisfaction questionnaire for nurses
Time frame: up to 28 days
No study locations are listed for this record.
Plan to share: No
This study is not yet recruiting, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.
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University Hospital, Grenoble