UC Trial Tests Non-Opioid Relief For Severe Post-Stroke Headaches

Key Takeaways

• BLOCK-SAH is enrolling patients recovering from SAH to compare ropivacaine plus dexamethasone injection with saline placebo.
• The primary objective is opioid use within 24 hours, with additional assessment of pain intensity, tolerability, safety, and vascular imaging.
• UC plans to enroll about 10 to 12 patients within a national study expected to include roughly 195 participants.

UC is enrolling patients in the BLOCK-SAH trial, a University of Florida-sponsored study in people recovering from subarachnoid hemorrhage, a type of stroke. The trial is comparing a non-opioid injection strategy with placebo during hospitalization for severe headache after SAH. UC expects to enroll about 10 to 12 patients at its site.

Patients recovering from subarachnoid hemorrhage commonly face a substantial headache burden during and after hospitalization. Nearly all patients experience headaches, and about 90% have severe pain rated 7 or higher on a 0 to 10 scale. Persistent headaches are also described as the fourth leading reason for emergency department return within one to three months after discharge. Opioid-based medications are a common current treatment, providing context for the intervention under study.

Investigators are testing ropivacaine and dexamethasone delivered by injection into the pterygopalatine fossa. The treatment targets the sphenopalatine ganglion and maxillary nerve. Patients are randomized to three treatment arms, and saline injection serves as the placebo condition. Enrolled patients receive the active trial drugs one to two times in a four-day window, with comparison during hospitalization after SAH.

The primary objective is to compare the study medications with placebo for reducing opioid use within 24 hours of injection. Secondary objectives include pain intensity, safety, patient tolerability, and vascular imaging outcomes. These measures define how the trial will be assessed, and no trial results are reported at this stage.

Charles Prestigiacomo is identified as the site principal investigator for the UC arm of the study. Across sites, about 195 patients are planned for enrollment nationwide. The trial is testing whether this inpatient approach reduces opioid exposure, and enrollment is ongoing at UC and other participating centers.