Barre(1982)指出,用5～10%可卡因溶液于蝶腭窝,对自发的和硝酸甘油诱发的丛集性头痛有速效,但长期应用容易成瘾或中毒。作者代以利多卡因滴鼻疗效良好。方法:诱发时舌下给硝酸甘油0.4mg,记录头痛开始时间。头痛发作后约5～10分钟,让病人取仰卧位,头后仰45°,并向头痛侧旋转30°～40°。慢慢滴入4%利多卡因1ml于头痛侧鼻孔内,保持头位数分钟。有的病人因鼻充血药液不能进入蝶腭窝时,可滴入几滴0.5%苯肾上腺素使充血消退后数分钟,再滴利多卡因。在首次用利多卡因后10分钟内评定疗效。若鼻充血不影响用药,则在初次滴药后3分钟评定疗效。若3分钟时头痛未完全缓解,可第2次滴药,过3分钟后再评定疗效。缓解程度以百分率计。头痛消退后可嘱病人带药自用,每2～3周随访一次。结果:5个病人经硝酸甘油诱发10次头痛,头 Barre (1982) pointed out that 5% to 10% cocaine solution in the sphenopalatine fossa has spontaneous and nitroglycerin-induced cluster headache with immediate effects, but long-term use is easily addicted or poisoned. The author replaces lidocaine on behalf of the good effect. Methods: When given sublingual nitroglycerin 0.4mg, record the start time of headache. Headache about 5 to 10 minutes after the attack, so that patients supine position, head back 45 °, and headache side rotation 30 ° ~ 40 °. Slowly drip 4% lidocaine 1ml in the headache side nostrils, keep the first few minutes. Some patients can not enter the sphenopalatine fossa due to nasal congestion drug solution, you can drop a few drops of 0.5% phenylephrine to make congestive subside after a few minutes, then drip lidocaine. Efficacy was assessed within 10 minutes of first use of lidocaine. If nasal congestion does not affect the medication, the first 3 minutes after the first assessment of efficacy. If 3 minutes when the headache is not completely relieved, the first 2 drops, over 3 minutes after the assessment of efficacy. Degree of remission as a percentage. Headache subsided after the patient can instruct patients with their own medicine, every 2 to 3 weeks follow-up time. Results: Five patients had 10 headaches with nitroglycerin