{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:15Z","timestamp":1756275015872,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,25]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>A 59-year-old woman underwent an open pancreaticoduodenectomy. Thoracic patient controlled-epidural anaesthesia provided excellent incisional pain relief; however, the patient experienced intractable left shoulder pain (10\/10 on the Numerical Rating Scale). To our knowledge, there is no effective established treatment for patients experiencing shoulder pain after an open pancreaticoduodenectomy. The patient\u2019s shoulder pain did not respond to medical management with acetaminophen, ketorolac, lidocaine transdermal patch, oxycodone and hydromorphone. Then, on postoperative day 2, the acute pain service was consulted. Considering that the sphenopalatine ganglion block has been previously reported to be helpful in a number of painful conditions, including shoulder tip pain after thoracic surgery, we offered this treatment to the patient. After just one topical sphenopalatine ganglion block, using a cotton-tipped applicator, the patient\u2019s shoulder pain entirely resolved and did not return. This is the first report of a successful treatment of intractable ipsilateral shoulder pain following an open pancreaticoduodenectomy with transnasal sphenopalatine ganglion block.<\/jats:p>","DOI":"10.1136\/bcr-2021-243746","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T11:35:53Z","timestamp":1641468953000},"page":"e243746","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Sphenopalatine ganglion block for ipsilateral shoulder pain following open pancreaticoduodenectomy"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5617-1907","authenticated-orcid":false,"given":"Danielle","family":"Levin","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Pain Medicine & Critical care, St Elizabeth\u2019s Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Acquadro","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Pain Medicine & Critical care, St Elizabeth\u2019s Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Cerasuolo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Pain Medicine & Critical care, St Elizabeth\u2019s Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederic","family":"Gerges","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Pain Medicine & Critical care, St Elizabeth\u2019s Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"2025082622374773000_15.1.e243746.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2018.01.041"},{"key":"2025082622374773000_15.1.e243746.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.01.018"},{"key":"2025082622374773000_15.1.e243746.3","unstructured":"Alexander CE , Dua A . 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Reply to DR Araujo, et al. Reg Anesth Pain Med 2019:rapm-2018-100189.","DOI":"10.1136\/rapm-2018-100189"},{"key":"2025082622374773000_15.1.e243746.13","article-title":"Sphenopalatine ganglion block for postdural puncture headache in the patient with challenging spinal anatomy","author":"Levin","year":"2021","journal-title":"Reg Anesth Pain Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:37:57Z","timestamp":1756273077000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,6]]},"published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1136\/bcr-2021-243746"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243746","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}