Study Evaluating Sphenopalatine Ganglion Block (SPGB) for Treatment of Postdural Puncture Headache (PDPH)

Postdural puncture headaches (PDPH) are a consequence of spinal and epidural anesthesia in
approximately 1% of cases when performed in obstetric patients. The gold standard treatment
for a PDPH is currently an epidural blood patch (EBP), which involves placing a needle back
into the epidural space of the neuraxium and then injecting 20 ml of the patient's own blood
through the needle and into the epidural space to form a clot over the insult in the tissue
layer that causes the headaches. The investigators want to test the efficacy of using a less
invasive procedure, called a sphenopalatine block (SPGB), for treatment of PDPH. SPGB has
been used for many years in the treatment of migraines and cluster headaches, and there are
several case reports of its use to successfully treat PDPH as well. SPGB simply involves
applying a local anesthetic to the mucosa in the back of each nostril to numb the nerves
that cause the headache. The investigators hope that the SPGB will reduce the number of PDPH
patients that require and EBP.