FAG’s on Sphenopalatine Ganglion Block in Las Vegas

The sphenopalatine ganglion is a mass of nerves that innervate the supply the head and face. The sphenopalatine ganglion block is a minimally invasive procedure used to treat different kinds of head and face conditions.

What is the sphenopalatine ganglion?

The sphenopalatine ganglion is located behind the nose and next to the jaw. The injection is given through the nostril. These nerves control pain sensations of the face and head region.

What conditions are treated with the sphenopalatine ganglion block?

The sphenopalatine ganglion block treats several disorders and syndromes. These include:

  • Migraine headache
  • Trigeminal neuralgia
  • Herpes zoster pain
  • Atypical facial pain
  • Neck and head pain
  • Temporomandibular joint dysfunction
  • Paroxysmal hemicranias
  • Sluder’s neuralgia

What happens before the sphenopalatine ganglion block procedure?

Before the sphenopalatine ganglion block, a nurse will discuss the risks and benefits with you and ask you to sign a consent form. Driving is not permitted for 24 hours after this procedure, so you must arrange to have someone drive you home. Go over all medications you are taking with the doctor, as blood-thinning agents must be held for several days beforehand.

Who should not have the sphenopalatine ganglion block?

Not everyone is a candidate for the sphenopalatine ganglion block. People who are not candidates for this procedure include those who:

  • Are pregnant – Because x-ray equipment and medications are used during this procedure, pregnant women are not permitted to have this block.
  • Have active infection – Notify the doctor if you feel ill or have a fever on the day of the procedure.
  • Have certain allergies – Be sure to notify staff of allergies to latex, medications, iodine, bandage material, and contrast dye.
  • Are taking certain medications – Blood-thinners must be held for several days, and patients with serious heart conditions cannot do without these.

What happens during the sphenopalatine ganglion block procedure?

After you change into a gown, the nurse places an IV catheter in your arm. Monitoring devices are used to assess blood pressure, heart rate, and oxygen levels. A cotton swab with a local anesthetic will be inserted into one nostril, and once numb, a small catheter is passed through the nostril and positioned near the nerves. Real-time x-ray is used to assure correct placement. After this, a long-acting anesthetic is injected on the nerves. If necessary, the doctor will use a special probe and radiofrequency energy to destroy a portion of the nerve root.

What should I expect after the procedure?

Expect mild pain after the procedure, which resolves in 2-6 hours. The soreness of the nostril and head is temporary and gradually goes away. The pain relief effect can last for up to six months, depending on the patient’s condition. You will be monitored for around 20-30 minutes by the recovery nurse, and should rest for the remainder of the day. Gradually return to normal activities as tolerated.

Is the sphenopalatine ganglion block effective?

Based on a recent clinical study where the sphenopalatine ganglion block was used to treat cancer head pain, researchers found that it was 88% effective. In a six-year study, the block had a 60% success rate for treating cluster headache.

What dangers are associated with the sphenopalatine ganglion block?

This block is a simple procedure, but as with all minimally invasive procedures, some risks can occur. These include blood vessel damage, nasal bleeding, infection, and nerve injury. Mild sedation used can produce side effects, such as drowsiness, dizziness, slurred speech, and confusion.

Resources

Cho DY, Drover DR, Nekhendzy V, Butwick AJ, Collins J, Hwang PH. The effectiveness of preemptive sphenopalative ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery. Int Forum Allery Rhino. 2011;1(3):212-8.

Ferrante FM, Kaufman AG, Dunbar SA, et al. Sphenopalatine ganglion block for the treatment of myofascial pain of the head, neck, and shoulders. Reg Anesth Pain Med. 1998;23(1):30-36.

Varghese BT, Koshy RC. Endoscopic transnasal neurolytic sphenopalatine ganglion block for head and neck cancer pain. J Laryngol Otol. 2001 May;115(5):385-7.