The use of transnasal sphenopalatine ganglion (SPG) block is safe and effective for providing short-term relief from acute migraine headaches, according to a study in Pain Research and Treatment.

Investigators retrospectively evaluated outcomes in 55 patients treated at a university medical center for migraine headache with bilateral transnasal SPG blocks during a 6-month period. The percentage of patients who were free of headache at 15 minutes, 2 hours, and 24 hours after treatment was the study’s primary efficacy outcome.

Pain was assessed using a 10-point numeric rating scale and patients were asked to report treatment-related adverse events, and to provide a global impression of change.

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At 15 minutes, 2 hours, and 24 hours after treatment with the SPG block, the percentage of patients free from headache was 70.9%, 78.2%, and 70.4%, respectively, and pain relief was 27.3%, 20%, and 22.2%, respectively. Numeric rating scale scores were reduced from baseline levels at 15 minutes, 2 hours, and 24 hours after the procedure (6.8 to 0.9, 0.6, and 0.8, respectively). A great majority of patients (98%) reported feeling “very good” or “good” with the global impression of change at 2 and 24 hours. In addition, only mild and transient adverse events were reported and included transient throat numbness (100%), nasal discomfort (18.2%), nausea (10.9%), vomiting (1.8%), and worsening of preexisting headache (1.8%).

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The primary limitation of the study is the lack of a placebo group.

“Transnasal SPG blockade is emerging as an effective and safe option for the treatment of several disabling headache and facial pain conditions such as migraine, cluster headache, and trigeminal neuralgia. Its ease of administration using noninvasive devices, safety profile, and quick pain relief makes it an attractive treatment option for these conditions,” noted the study authors. 

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Binfalah M, Alghawi E, Shosha E, Alhilly A, Bakhiet M. Sphenopalatine ganglion block for the treatment of acute migraine headache. Pain Res Treat. 2018;2018:2516953.