Severe headache is one of the most distressing symptoms experienced by patients with aneurysmal subarachnoid hemorrhage (SAH). In the neurocritical care setting, pain control often relies on opioid medications—drugs that can cause sedation and complicate frequent neurologic examinations during a critical period of recovery.
A new clinical trial underway at UNC Neurology, known as BLOCK‑SAH, is testing an innovative, non‑opioid approach to managing SAH‑associated headache. The study evaluates whether bilateral pterygopalatine fossa blockade—a targeted nerve block technique—can safely reduce headache severity while minimizing the need for opioid medications.
By focusing on regional pain control rather than systemic medications, researchers hope this approach will allow patients to remain more awake, engaged, and neurologically assessable during their ICU stay. If successful, BLOCK‑SAH could offer clinicians a new tool to improve comfort without compromising safety or monitoring.
Eligible participants include adults admitted with aneurysmal SAH who are not intubated and able to request pain medication. Participation involves brief bilateral injections performed over several days, alongside continued standard clinical care. Pain scores, medication use, and safety outcomes are closely monitored throughout hospitalization.
Enrollment began in early April, with the study projected to continue through July 2027. Because the technique does not require novel medications or specialized equipment, successful results could be translated into clinical practice relatively quickly.
Ultimately, BLOCK‑SAH reflects UNC Neurology’s commitment to advancing patient centered care in neurocritical illness—addressing not only survival, but comfort, safety, and recovery during one of the most vulnerable moments in a patient’s life