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F\u00fchren konservativ-medikament\u00f6se Therapieversuche nicht zu einer Symptomlinderung, empfehlen aktuelle Leitlinien die fr\u00fchzeitige Durchf\u00fchrung eines epiduralen Blut-Patch. Als potenzielle Alternative wird die transnasale Blockade des Ganglion sphenopalatinum mittels Lokalan\u00e4sthetika diskutiert.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methode<\/jats:title><jats:p>In dieser Falldarstellung wird erstmals von einer Modifikation dieser Technik unter Anwendung eines Medikamentenzerst\u00e4ubers (\u201emucosal atomization device\u201c [MAD]) zur Therapie eines PDPH bei zwei geburtshilflichen Patientinnen berichtet. \u00dcber dieses Verfahren existieren bislang keine Erfahrungen aus der geburtshilflichen An\u00e4sthesiologie.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ergebnisse<\/jats:title><jats:p>Die erste Patientin (25-j\u00e4hrige Zweitgravida, BMI 54,7\u202fkg\/m<jats:sup>2<\/jats:sup>) zeigte am ersten Tag nach Sectio caesarea in Spinalan\u00e4sthesie einen ausgepr\u00e4gten PDPH mit starker \u00dcbelkeit und Erbrechen. Bei der zweiten Patientin (32-j\u00e4hrige Drittgravida, BMI 27,3\u202fkg\/m<jats:sup>2<\/jats:sup>) kam es 4\u00a0Tage nach Spontanpartus unter Periduralan\u00e4sthesie zu einer PDPH-bedingten Wiederaufnahme. W\u00e4hrend konservative Ma\u00dfnahmen sowie Therapieversuche mit Nichtopioidanalgetika und Koffein keinen hinreichenden Behandlungserfolg erzielten, f\u00fchrte die intranasale Lidocainapplikation mittels MAD zu einer unmittelbaren und persistierenden Linderung der Beschwerden. Von beiden Patientinnen wurde die Lidocaingabe sehr gut vertragen; sie konnten am Folgetag aus dem Krankenhaus entlassen werden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Schlussfolgerung<\/jats:title><jats:p>Die vorgestellte nichtinvasive und einfach durchzuf\u00fchrende Ma\u00dfnahme stellt eine wertvolle Erg\u00e4nzung bisheriger Therapieoptionen und eine potenzielle Alternative zum epiduralen Blutpatch bei geburtshilflichen Patientinnen mit PDPH dar.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00101-020-00900-9","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T13:03:05Z","timestamp":1607605385000},"page":"392-397","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intranasale Lidocainvernebelung als neue und nichtinvasive Therapieoption des Postpunktionskopfschmerzes","Intranasal lidocaine atomization as novel and noninvasive treatment option for postdural puncture headache"],"prefix":"10.1007","volume":"70","author":[{"given":"Benedikt Hermann","family":"Siegler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Gru\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Oehler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ke\u00dfler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Fluhr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Weis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus Alexander","family":"Weigand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"900_CR1","series-title":"Registernummer 001-038","volume-title":"AWMF-Leitlinie \u201eDie geburtshilfliche Analgesie und An\u00e4sthesie. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. F\u00fcr Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, \u00fcber die Patienten zu identifizieren sind, liegt von ihnen und\/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}