The purpose of this study is to evaluate the effect of the ganglion sphenopalatine block (SPG block) on persistent headache following acute COVID-19 infection.
Adult patients with persistent headache following COVID-19 infection will be enrolled in the
study. The patients will be randomised into three groups; bilateral SPG-block withto receive
local anesthetic (lidocaine + ropivacaine), bilateral SPG-block with placebo (isotone NaCl)
or bilateral "sham"-block with placebo (isotone NaCl).
Primary outcome is hyperactivity in the sphenopalatine ganglion assessed by pain intensity
(0-100mm on a visual analogue scale, VAS) of the headache in standing position 30 minutes
after block in the group Ropicavain-Lidocain and "sham".
Procedure: Sphenopalatine Ganglion Block with Local Anesthetic
Block performed with bilaterally inserted q-tips with 1:1 mixture of lidocaine 40mg/ml and ropivacaine 5mg/mL
Procedure: Sphenopalatine Ganglion Block with Placebo (Isotone NaCl)
Block performed with bilaterally inserted q-tips with isotone NaCl
Procedure: "Sham"-block with Placebo (Isotone NaCl)
Block performed with bilaterally inserted q-tips with isotone NaCl. The q-tips are inserted a maximum of 3 cm into the nasopharynx thus not reaching the mucus above the ganglion.
Inclusion Criteria:
- Age > 18 years
- Moderate to severe headache (NRS >= 3) with self reported duration of minimum 6 hours
during the past week as well as moderate to severe headache (NRS >= 3) on the day of
intervention.
- Onset of headache during or maximum 4 weeks after PCR-verified COVID-19 infection.
- Headache must have persisted for at least 4 weeks following COVID-19 diagnosis.
Exclusion Criteria:
- Patients who cannot cooperate to the study
- Patients who does not understand or speak Danish
- Allergy to the drugs used in the study
- Has taken opioids within 12 hours prior to intervention
- History of migraine or persistent headache before COVID-19 infection.
- Active COVID-19 infection (defined by the Danish Goverment regulations, i.e. 48 hours
after last symptoms (omitting long term effects) or 7 days after positive COVID-19
test if no symptoms.
Bispebjerg and Frederiksberg Hospital, University of Copenhagen
Copenhagen, Denmark
Christian S Meyhoff, PhD, Study Director
University Hospital Bispebjerg and Frederiksberg