Abstract
Background: PDPH is a well-recognized complication of anesthesia in the neuraxial. Few cases have been reported in children. EBP is more difficult in children, as it requires sedation or even general anesthesia. The SPG block is an effective, low-risk treatment option for PDPH refractory to conservative management. We will report a case of unnoticed accidental perforation of the dura mater, with the appearance of PHPD 48 hours after anesthesia, treated with SPG block. Case report: Female patient, aged 3 years and 9 months, weighing 20 kg, ASA I. Coagulogram and complete blood tests were normal. Abbreviation of fasting with orally 10 ml/kg of 12.5% maltodextrin between 2-4 hours before umbilical hernia correction. Monitoring, venoclysis (#22G), inhalation anesthesia with sevoflurane under the Baraka method. Asepsis and antisepsis, lumbar puncture with pediatric epidural needle (22G), injection 10 ml 0.25% levobupivacaine. The surgery duration is 40 minutes. PACU without motor blockage of the lower limbs. After 48 hours, she sought emergency care at the hospital with a typical PDPH after accidental puncture of the dura mater, without the anesthesiologist's perception. On the 5th postoperative day, the child presented refractoriness, leading to limitations in daily activities, SPG block with 1% lidocaine was performed with immediate success. Discharged home without a headache. Conclusion: Occurrence of PDPH after lumbar puncture in children is rare. SPG block has been an alternative for the use of EBP. The novel approach described in this report has minimal risks of discomfort or injury to the nasal mucosa. We believe that SPG block is a feasible, easy, safe, inexpensive, and well-tolerated treatment, being an option for the treatment of PDPH in children. Using five publishing sites this is the 1st SGP block in children.
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