Sphenopalatine ganglion block for postdural puncture headache: A review of current evidence

Table 2 Chronological summary of key systematic reviews and meta-analyses on postdural puncture headache management

Ref.	Type of review	Key focus	Included studies (n)	Key interventions	Main conclusion and finding
Basurto Ona et al[15], 2015	Cochrane review	Pharmacological treatment	13 RCTs	Caffeine, gabapentin, and theophylline	Evidence for the benefits of these drugs is limited owing to small, biased studies, although some drugs have shown promise
Barati-Boldaji et al[16], 2023	Meta-analysis	Aminophylline/theophylline	15 studies	Aminophylline, theophylline	They showed potential for treatment but not for prevention
Chang et al[17], 2021	Meta-analysis	GON block (treatment)	7 studies	Greater occipital nerve block	GONB is effective for short-term PDPH pain relief
Giaccari et al[18], 2021	Systematic review	Nerve blocks (treatment)	19 studies	SPG block, GONB, LON block	Peripheral nerve blocks are promising and safe options
Zhao et al[19], 2023	Bayesian network meta analysis	Pharmacological prevention	22 RCTs	Propofol, ondansetron, and amin	Propofol, ondansetron, and aminophylline were the most effective in reducing PDPH incidence
Dwivedi et al[20], 2023	Meta-analysis	SPG block (treatment)	9 RCTs	Trans-nasal SPG Block	The SPG block was effective for immediate pain relief compared to the controls, but the effect was short-lived
Alatni et al[3], 2024	Systematic review	Multi-modal (treatment and prevention)	38 studies	Pharmacologic, nerve blocks, EBP	Various effective strategies were summarized, and EBP was affirmed as the gold standard

RCT: Randomized controlled trial; GONB: Greater occipital nerve block; PDPH: Postdural puncture headache; SPG: Sphenopalatine ganglion; EBP: Epidural blood patch.