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Table 6 Studies of SPG blocks for operative pain of the head and face

From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review

Operative Pain of the head and neck
Author Year Medical problems Approach Imaging Medication Number of cases Study design Outcome
Robiony et al. [24] 1998 Skeletal transverse discrepancy of the maxilla Transcutaneous truncal anesthesia of the maxillary nerve in association with transmucosal anesthesia of the sphenopalatine ganglion None Prilocaine carbocaine cream 12 Case series Total anesthesia of the maxillary area facilitated the operations and appreciably reduced amount of postoperative pain
Hwang et al. [23] 2003 Removal of nasal packing after nasal operation Needle injection into the greater palatine canal None 1% lidocaine 11 Case-control Injection side had significantly lower pain than the control side
Ahmed et al. [18] 2007 Endoscopic sinonasal surgery intraoperative isofluorane consumption, hypotensive agents used, postoperative pain Bilateral SPG block, injected between the middle and inferior turbinates None 0.5% lidocaine and epinephrine. 15 cases, 15 controls Randomized-controlled Significantly reduced intraoperative isofluorane consumption and esmolol use, postoperative tramadol use and postoperative pain.
Ali et al. [20] 2010 Endoscopic trans-nasal resection of pituitary adenoma, anesthetic, vasodilator and analgesic sparing effect Bilateral SPG block, injected between the middle and inferior turbinates None 1.5% lidocaine and epinephrine 15 cases and 15 controls Randomized-controlled Significantly reduced in sevoflurane and nitroglycerine consumption, emergence time, postoperative pain and need of meperidine analgesia.
Kesimci et al. [22] 2012 Endoscopic sinus surgery postoperative analgesia efficacy Bilateral SPG block, injected between the middle and inferior turbinates None 0.5% bupivacaine or 0.5% levobupivacaine 45 Double-blind randomized, placebo-controlled Postoperative pain significantly reduced, also significantly few patients requiring additional analgesics in the postoperative 24 h.
Demaria et al. [21] 2012 Endoscopic sinus surgery postoperative analgesia efficacy Bilateral SPG block, palatal approach None 2% lidocaine and 1% tetracaine 70 Double-blind randomized, placebo-controlled Patients were discharged sooner than the control group. The block group also required less total fentanyl in the recovery room.
Al-Qudah et al. [19] 2015 Endoscopic sinus surgery postoperative analgesia efficacy Applied to the SPG region None 2% lidocaine and epinephrine 60 (30 cases, 30 controls) Double-blind, placebo controlled Significant pain reduction in the SPG block group