Images in anesthesiology: three safe, simple, and inexpensive methods to administer the sphenopalatine ganglion block

Abstract

The sphenopalatine ganglion (SPG) block is a simple and valuable technique that was discovered over a century ago, but, unfortunately, very few anesthesiology providers are familiar with this block. After some of our recent publications, physicians from different countries have reached out to us requesting more specifics on how we perform our version of the block. In this report, we provide a brief history of the block and demonstrate our three effective, simple, readily available, and inexpensive methodologies with images. We are proud to share that our three SPG block techniques have so far effectively relieved patients of chronic migraines, acute migraines, tension headaches, moderate-to-severe back pain, and post-dural puncture headaches.

Sphenopalatine ganglion block for ipsilateral shoulder pain following open pancreaticoduodenectomy

“…Since there is only one sphenopalatine ganglion, the commonly accepted SPGB technique is to place local anaesthetic topically by way of both the left and right nasal passages local anesthetic-soaked swabs, contributing to successful transmucosal reach and coverage of the SPG. 9 However, the sphenopalatine ganglion is a bilateral structure, so, in theory, a block just through the left nasal passage could have also potentially achieved the observed result. There are several commercially available devices available to perform SPGB, but the administration of this block via the assembly of cotton-tip applicators from supplies that are readily available in most medical centres is simple and inexpensive.…”

Sphenopalatine Ganglion Block Relieves Chronic Abdominal Wall Pain!

“…There are several commercially available devices available to perform sphenopalatine ganglion blocks, but the administration of this block via the use of just long cotton-tips soaked in viscous Lidocaine 2% makes this treatment simple and inexpensive [3]. The fascinating aspect of this block is that not only does it treat numerous pain conditions, including headaches of various etiologies, neck pain, back pain, post-operative shoulder pain, and now chronic abdominal wall pain, but it also, somehow, provides long-term effect.…”

“…However, all of these treatments provided only minimal relief. Considering that the sphenopalatine ganglion block had previously been shown to relieve pain of various etiologies, we offered this treatment option to this patient [3][4][5][6][7].…”

Facing postdural puncture headache in COVID-19 times

“…We read with great interest the recent report by Levin and Cohen 1 describing safe, simple and inexpensive methods to administer the sphenopalatine ganglion block (SGB). We are aware of their previous work showing a faster relief by SGB and fewer complications than epidural blood patch (EBP).…”