Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery

Kesimci, Elvin; Öztürk, Levent; Berçin, Sami; Kırış, Muzaffer; Eldem, A.; Kanbak, Orhan

doi:10.1007/s00405-011-1702-z

Cited by 39 publications

(41 citation statements)

References 13 publications

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“…No other systematic review or meta‐analysis was found pertaining to perioperative and postoperative analgesic use for endoscopic sinus surgeries. Thirty‐two studies met the inclusion criteria for this project: all of the included studies were randomized, controlled trials (RCTs). Using the Cochrane Bias tool, we judged 4 studies to be at high risk, 21 to be at moderate risk, 6 to be at low risk, and 1 to be at unclear risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies associated the use of local agents, including lidocaine, with lower postoperative VAS scores and lower overall analgesic requirements in the postoperative period. Notably, several studies indicated decreased analgesic requirements extending beyond the length of action of these agents, with postoperative effects lasting throughout the 24‐hour postoperative period . The various agents that have been examined are further detailed in Supplementary Table ; importantly, 5 of 8 studies included contained level 1b evidence (Table ).…”

Section: Discussionmentioning

confidence: 99%

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Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

Svider

Nguyen

Yuhan

et al. 2018

Int Forum Allergy Rhinol

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There is evidence supporting the use of NSAIDs and gabapentin for the control of pain after endoscopic sinus surgery. Acetaminophen, α-agonists, and local anesthetics are also viable options for postoperative analgesia. Familiarity with these data is essential to facilitate the use of opioid alternatives. Further large-scale, multi-institutional, randomized trials are needed to provide conclusive recommendations for these perioperative analgesics.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

Svider

Nguyen

Yuhan

et al. 2018

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…reported that blood loss was significantly lower in patients who had SPGB through the posterior palatine canal route. Kesimci et al . evaluated the effect of SPGB in the control of nasal bleeding during endoscopic sinus surgery.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery

Ekici

Alagöz

2019

Int Forum Allergy Rhinol

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Background: This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty.Methods: Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours a er surgery), overall satisfaction with the pain control (end of 24 and 168 hours a er surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded.Results: Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours a er surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower anal-gesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours a er surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001).Conclusion: SPGB with bupivacaine is a safe and effective method to reduce pain a er septoplasty, and it is a costeffective alternative to high doses of analgesics. C 2019 ARS-AAOA, LLC. How to Cite this Article: Ekici NY, Alagöz S. The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain a er septal surgery. Int Forum Allergy Rhinol. 2019;9:1521-1525.E ffective management of postoperative pain is a critical component of nasal surgery. Insufficient pain management can lead to poor outcomes, including decreased patient satisfaction, long-term hospitalization and delayed resumption of work, treatment with high doses of analgesics, and increased healthcare costs. Despite considerable improvements in analgesia and surgical techniques, there is no consensus for pain control and avoidance of overprescription after nasal surgery. Numerous pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDS), gabapentin with or without intravenous dexamethasone,

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“…20 On the contrary, Kesimci et al reported that either bupivacaine or levobupivacaine provided effective postoperative analgesia after FESS. 21 The use of sympatholytic drugs (dexmedetomidine and clonidine) is proven for better hemodynamic stability. 22,23 The topical SPGB dates back to the previous century with the use of cocaine topical for minimal surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Regional Anesthesia as Supplementation to General Anesthesia in Endonasal Surgeries

Naik¹

2019

Journal on Recent Advances in Pain

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Background: Endoscopic surgeries are minimally invasive surgeries to treat sinus pathologies. The challenges faced by the anesthesiologist are to provide bloodless field of surgery, to maintain hemodynamic stability, and to reduce anesthetic supplementation to facilitate early recovery of the patient. The preferred anesthesia is general with controlled ventilation, stable surgical field, and airway protection with adequate anesthesia. Problems faced during the procedure are to keep the minimum the bleeding during surgery so that a better visibility of the endoscopic magnified surgical field, faster awakening after reversal of general anesthesia, faster return of protective airway reflexes, and optimal postoperative analgesia. Sphenopalatine ganglion block (SPGB) has proven an effective adjuvant to general anesthesia during sinonasal surgery. Reduced bleeding increases visibility and reduces operative time with reduced complications and better results. In our study, SPGB was supplemented with the general anesthesia to evaluate the comfort of operability, opioid supplementation, inhalation anesthetic requirement, and intraoperative and postoperative complications. Materials and methods: Our study is a randomized controlled triple-blind study with 30 patients in each group. In both the groups, general anesthesia was given. In group I, SPGB was given with a 10 mL of 1% xylocaine local anesthetic, and in group II, SPGB was given with placebo. Results:We have observed that there is a reduced intraoperative and postoperative bleeding in group I, the field of vision is better in group I, and fentanyl supplementation and isoflurane consumption was less in group I. The intraoperative and postoperative complications were less in group I. Conclusion: Sphenopalatine ganglion block regional anesthesia is reliable supplementation to general anesthesia in endonasal endoscopic procedures to provide stable surgical field with reduced anesthetic requirement and minimal intraoperative and postoperative complications.

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Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery

Cited by 39 publications

References 13 publications

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence‐based review

The effectiveness of endoscopic sphenopalatine ganglion block in management of postoperative pain after septal surgery

Regional Anesthesia as Supplementation to General Anesthesia in Endonasal Surgeries

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