Podcast #243: Sphenopalatine Nerve Block

Podcast #243: Sphenopalatine Nerve Block

Author: Don Stader, M.D.

Educational Pearls

  • Cluster headaches are usually intense, unilateral, and involve the periorbital area.
  • CN V (Trigeminal) provides sensory and autonomic innervation the face and eyes, which play roles in headache pathology.
  • Cluster headaches can be treated with high flow oxygen, but a new treatment involves blocking the sphenopalatine ganglion (SPG) with lidocaine. Because sensory and autonomic branches of the trigeminal traverse the SPG, lidocaine will effectively treat a cluster headache.
  • To block the ganglion, intranasal lidocaine may be used, or a Q-tip soaked in 4% lidocaine can be applied to the most posterior aspect of the pharynx for 10-15 minutes.

References: https://www.aliem.com/2017/03/trick-sphenopalatine-ganglion-block-primary-headaches/

Jaksot(1147)

Podcast # 328:  Sleep Deprivation

Podcast # 328: Sleep Deprivation

Author: Sam Killian, MD Educational Pearls: Insufficient sleep and disrupted circadian rhythms are a major health problem today Millions of dollars, thousands of deaths, and millions of injuri...

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Podcast # 327: No More Hemoccults

Podcast # 327: No More Hemoccults

Author: Don Stader, MD Educational Pearls: The use of fecal occult blood tests is falling out of favor in emergency departments These tests have strong evidence suggesting their efficacy in colon...

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Podcast # 326: Valley Fever

Podcast # 326: Valley Fever

Author: Michael Hunt, MD Educational Pearls: Valley fever is a fungal infection known as Coccidiomycosis that can present with vague symptoms like cough, fever, myalgias. A thorough history is crit...

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Podcast #325: Vaping and Pneumonia

Podcast #325: Vaping and Pneumonia

Author: Sam Killian, MD Educational Pearls: Being exposed to E-cigarette vapor may increase risk of pneumonia. Recent study has shown e-cigarette vapor increases quantities of Platelet-activating-rec...

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Podcast #324: Superwarfarin

Podcast #324: Superwarfarin

Author: Rachel Beham, PharmD Educational Pearls: Some synthetic cannabinoids have been contaminated with Brodifacoum. Brodifacoum is a Vitamin K antagonist and can present with a severe coagulopathy....

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Podcast #323: Calcium Channel Toxicity

Podcast #323: Calcium Channel Toxicity

Author: Jared Scott, M.D. Educational Pearls: Cardiac myocytes and vascular smooth muscle are dependent on an intracellular calcium influx for contraction. Pancreatic beta cells rely on calcium to re...

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Podcast #322: Methemoglobinemia

Podcast #322: Methemoglobinemia

Author: Nick Hatch, M.D. Educational Pearls: Methemoglobinemia is when the iron in hemoglobin is in the Fe3+ (ferric) state rather than the normal Fe2+ (ferrous) state. Methemoglobin cannot releas...

27 Huhti 20184min

Podcast #321: Migraine Treatment in ED

Podcast #321: Migraine Treatment in ED

Author: Jared Scott, M.D. Educational Pearls: Recent study compared Compazine with Benadryl vs. Dilaudid for acute migraine management in the ED. Compazine + Benadryl demonstrated migraine relief...

25 Huhti 20183min

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