The Effect of Sphenopalatine Ganglion Block on Headache and Vasalgia

The purpose of this study is to evaluate the effect of sphenopalatine ganglion block (SPG block) on headache and veisalgia (hangover) the day after attending the metal festival Copenhell.

Headache is one of the most commonly reported symptoms following heavy alcohol consumption and is expected to be particularly pronounced after exposure to noisy environments. Headaches can have negative consequences such as reduced cognitive function and absence from school or work despite treatment with basic pain medication.

A Danish study has previously shown that SPG block is effective against some of the most severe types of headache (e.g., post-dural puncture headache and migraine), but its potential after participation in a music festival has not yet been explored.

The mechanism and pathophysiology behind headache and veisalgia after significant alcohol intake are not well understood but are believed to be multifactorial. Headache following alcohol consumption is thought to arise from a dysreflexia that leads to cerebral vasodilation, which causes the headache. This cerebral vasodilation is mediated by the parasympathetic nervous system, partly via neurons in the sphenopalatine ganglion (SPG), which is located at the back of the nasal cavity.

Treatment that inhibits this vasodilation by blocking the SPG is still relatively new in Denmark, but a Danish study has demonstrated its effect on post-dural puncture headache, where it was found to potentially cure more than half of the cases, thus sparing patients further invasive treatment. However, the study concluded that much of the block's effect could not necessarily be attributed to the local anesthetic but might instead be due to mechanical stimulation of the ganglion.

In addition to its effect on post-dural puncture headache, the block has also been shown to be effective in migraine, where a similar mechanism is assumed.

The treatment with transnasal sphenopalatine ganglion block (SPG block) is simple and minimally invasive, performed by gently inserting a cotton swab with local anesthetic through the patient's nostril to the back wall of the nasal cavity where the ganglion is located. The block has few reported side effects and can be performed with minimal resources.

Screening Criteria:

• Age ≥ 18 years
• Expected to consume a large amount of alcohol at the metal festival Copenhell
• Expected to be able to cooperate during block administration
• No known history of migraine, chronic headache, or allergy to substances used in the study
• Able to understand and speak Danish

Inclusion criteria

• Meets screening criteria and is present on the day of intervention
• Moderate to severe headache (defined as ≥ 3 on a 0-10 VAS) on the day of intervention

Exclusion criteria

• Intake of alcohol or other intoxicating substances after waking up on the day of intervention.