The Effect of Sphenopalatine Ganglion Block on the Postoperative Pain in Patients Undergoing Septorhinoplasty

Degirmenci, Nazan; Ozdem, Abdullah; Uysal, Harun; Sen, Pelin; Şentürk, Erol; Özturan, Orhan; Türköz, Ayda

doi:10.1177/0003489420909417

Cited by 14 publications

(9 citation statements)

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“…[ 17 ] The pre-emptive analgesic effect of sphenopalatine ganglion block with different local anaesthetics has been studied in patients undergoing functional endoscopic sinus surgery, which also demonstrated similar findings. [ 19 20 ] The use of nasociliary and infraorbital nerve blocks as the sole anaesthetic technique in outpatient nasal surgeries has shown encouraging results by providing good intraoperative conditions in 20 out of 24 patients. [ 6 ] However, the study reported a failure rate of 13% (4 out of 24 cases).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of pre-emptive nerve block on opioid consumption in patients undergoing nasal surgery under general anaesthesia: A double-blinded randomised controlled study

Saravanan

Parthasarathy

Krishnapriyanka

2022

Indian Journal of Anaesthesia

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Background and Aims: The efficacy of bilateral nasociliary and maxillary nerve blocks combined with general anaesthesia on intraoperative opioids consumption, emergence and recovery outcomes in adult patients is not well established. We conducted this study to test the hypothesis that the above blocks, combined with general anaesthesia, decrease the intraoperative opioid consumption following nasal surgery. Methods: In this prospective, double-blinded, randomised controlled study, 51 adult patients undergoing elective nasal surgery under general anaesthesia were randomised into one of two groups. Group A ( n = 26) received bilateral nasociliary and maxillary nerve blocks with 12 mL of equal volumes of 0.5% bupivacaine and 2% lignocaine after induction of general anaesthesia. Group B ( n = 25) did not receive any block (control group). The primary endpoint was the total intraoperative dose of fentanyl consumed. The secondary endpoints were the grade of cough, emergence agitation, the grade of post-operative nausea and vomiting, time to the first analgesia and time to post-anaesthesia care unit discharge. Results: The mean total intraoperative fentanyl dose (μg) was significantly lower in group A than in group B (2.31 ± 11.76 vs. 41.20 ± 31.00, P = 0.00). The incidence of emergence agitation was lower in group A than group B (11.5% vs. 88%, P = 0.00). The time to the first analgesia was significantly longer in group A than group B (543.27 vs. 199.84 min, P = 0.017). Conclusion: The pre-emptive administration of bilateral nasociliary and maxillary nerve block for nasal surgery is an effective technique for reducing the intraoperative dose of fentanyl and emergence agitation.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of pre-emptive nerve block on opioid consumption in patients undergoing nasal surgery under general anaesthesia: A double-blinded randomised controlled study

Saravanan

Parthasarathy

Krishnapriyanka

2022

Indian Journal of Anaesthesia

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“…В ходе поиска выявили 134 релевантных исследования, 34 из них были дублирующими публикациями. Далее были изучены оставшиеся 100 исследований (2569 пациентов), из них 14 исследований (424 пациента) содержали критерии исключения, то есть КНБ выполнялась как компонент сочетанный анестезии, например применение интраоперационно в лор-хирургии [13] и при хирургии врожденных дефектов верхней челюсти у детей [14], а также те исследования, где КНБ сочеталась с блокадой большого затылочного нерва [15]. Из оставшихся 86 исследований (2145 пациентов) были исключены 13 обзоров и 50 исследований, не являющихся РКИ (1555 пациентов).…”

Section: результаты отбор исследованийunclassified

“…Существуют разные доступы к крылонебному узлу: интраназальный [1], над-и подскуловой [2]. На сегодня крылонебная блокада (КНБ) часто используется как компонент анальгезии в лор-хирургии [3], а также в офтальмохирургии [4]. В данном обзоре сделан акцент на анальгетическом эффекте КНБ как самостоятельного метода обезболивания, вне зависимости от способа выполнения крылонебной блокады.…”

Section: Introductionunclassified

The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

Oleshchenko

Юрьева

Заболотский

2023

Kuban. nauсh. med. vestnik

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Background. The use of regional blockades for the purpose of analgesia is widely used in all fields of medicine, however, the analgesic efficacy of the pterygopalatine blockade, as an independent method of treating pain of various genesis, has not been studied enough. Therefore, there is a need to analyze the results of clinical trials to evaluate the analgesic efficacy of the pterygopalatine blockade as an independent method of anesthesia.Objective — to investigate the analgesic effect of pterygopalatine blockade as a monotherapy in patients with pain of various origins of oculotemporal area, conducting a meta-analysis of published results of randomized clinical trials.Methods. The methodology involved a systematic literature search by means of PubMed, MEDLINE, EMBASE, and Cochrane Library search engines. The search covered the period of the past 10 years and had the following criteria: a double-blind, randomized, controlled study of the use of pterygopalatine blockade with a local anesthetic versus placebo. For each included study, a standardized magnitude of the analgesic effect of pterygopalatine blockade compared to placebo was calculated, with pain assessing in 15, 30, and 60 minutes after the blockade was performed. Meta-analyses were conducted for each endpoint. Meta-analysis was performed using Stata 11.0 application programs ((The Cochrane Collaboration, Oxford, United Kingdom).Results. Five randomized controlled trials involving 269 patients met the inclusion criteria, and involved analyzing the pterygopalatine blockade with local anesthetic (n=140) against placebo (n=129). In 15 minutes after pterygopalatine blockade was performed, the difference in mean pain intensity compared to the control group was -2.5 points, the mean level was lower in the pterygopalatine blockade group, MD=-2.5 [95% CI -3.7; -1.7]. After 30 minutes: -2.7 points, MD=-2.7 [95% CI -4.5; -1.5], after 60 minutes: -1.7 points, MD=-1.7 [95% CI -4.0; -0.5]. The relative risk of adverse effects, such as nasopharyngeal symptoms, after performing a pterygopalatine blockade with a local anesthetic accounted for (RR =1.31 [95% CI 0.5–3.04]). In this regard, the incidence of complications and their variants that can be caused by pterygopalatine blockade is a matter for further clinical research.Conclusion. The results obtained in the meta-analysis testify to the analgesic effect of the pterygopalatine blockade as a monotherapy in patients with pain of different origins oculotemporal area in 15, 30, and 60 minutes after its performance. These data may be relevant when choosing a method for first-line anesthetic management of pain syndrome of oculotemporal area.

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“…The inability to perform an infraorbital blockade to anesthetize during surgery of the inferior orbital rim wall is associated with the displacements of bone fragments in the infraorbital foramen after the fracture [7]. In this regard, the analgesic effect of the pterygopalatine blockade (PPB) is of interest, which is successfully used in otolaryngology, maxillofacial surgery and as an interventional technique for acutemigraine headache, cluster and chronic facial pain, as well as in the treatment of postdural puncture pain syndrome, post-herpetic neuralgia [8,9].…”

Section: Introductionmentioning

confidence: 99%

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

OP¹,

AV²,

DV³

2022

Act Scie Ortho

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The analgesic effect of the pterygopalatine blockade is successfully used as anesthesia in otolaryngology, with volumetric surgical interventions in the maxillofacial region and as an interventional method for the treatment of migraine, cluster and chronic facial pain, in the treatment of post-functional pain syndrome, postherpetic neuralgia.The purpose of this study is to evaluate the analgesic effect of the infra zygomatic access of performing a pterygopalatine block as a component of combined anesthesia during reconstructive surgery for fractures of the lower orbital edge. Research and Design:The study was carried out at Irkutsk Branch of S. Fyodorov "Eye microsurgery" Federal State Institution of Ministry of Health of the Russian Federation. 9 male patients with the fractures of the lower orbital edge were included.Material and Methods: Pterygopalatine blockade as a component of combined anesthesia was performed through a infrazygomatic access by the impegnation technique for pain management in reconstruction of the inferior orbital rim wall. A 25 mm needle with a 23G diameter was used to anesthetize the pterygopalatine ganglion and the maxillary nerve with solutions of local anesthetics (lidocaine 2% -2 ml and ropivacaine 0.75% -2 ml). The following parameters were evaluated: the adequacy of anesthesia, the duration of the analgesic effect of the pterygopalatine blockade by Verbal Rating Scale, the appointment of additional anesthesia, patient comfort, complications after the blockade.Results: Pterygopalatine blockade as component of a combined anesthesia was effective intraoperatively and didn't cause hemodynamic changes during surgery. During a postoperative period, patients felt comfortable without pain. No additional anesthesia required. The length of the block varied from 4 to 6 hours. Such complications as hemorrhages, intravascular injection of anesthetic, trauma of neural structures were not noticed. Conclusion:Pterygopalatine block is a good alternative to both intra and post operative anesthesia in reposition of the inferior orbital rim wall.

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The Effect of Sphenopalatine Ganglion Block on the Postoperative Pain in Patients Undergoing Septorhinoplasty

Cited by 14 publications

References 14 publications

Effectiveness of pre-emptive nerve block on opioid consumption in patients undergoing nasal surgery under general anaesthesia: A double-blinded randomised controlled study

Effectiveness of pre-emptive nerve block on opioid consumption in patients undergoing nasal surgery under general anaesthesia: A double-blinded randomised controlled study

The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis

Regional Blockades in the Perioperative Period during the Reposition of the Inferior Orbital Rim Wall

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