What is a Sphenopalatine Ganglion Block?

Sphenopalatine ganglion blocks explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Pterygopalatine RegionA sphenopalatine ganglion block is a commonly utilized treatment for atypical face pain, headaches, neuralgia, and additional painful conditions. The sphenopalatine ganglion is a nerve bundle that is located in the pterygopalatine fossa bone cavity directly under the nose and is a part of the parasympathetic, sympathetic, and sensory nervous systems.

For many years, this nerve bundle has been the primary focus of research for headache relief. Headache treatments in the early 1900s involved soaking cotton in alcohol and then applying it to the head or even the use of cocaine. These techniques were especially effective at relieving nasal headaches because alcohol and cocaine block the activity of the nerves within the sphenopalatine ganglion and, in doing so, hinder pain signal transmission. Presently—thankfully—atypical face pain, migraines, and cluster headaches are instead often treated with a sphenopalatine ganglion block.

How is a Sphenopalatine Ganglion Block Performed?

Preparation For ProcedureThe sphenopalatine ganglion block is a quick outpatient procedure that is minimally invasive. This approach involves administering anesthesia to the nerve bundle of the sphenopalatine ganglion in order to prevent or block the transmission of pain signals from the nerves to the brain. Physicians have established several techniques that can be utilized to deliver the anesthesia to the nerve bundle such as the lateral, transnasal, and the transoral approach.

The quickest and most commonly utilized approach is the transnasal method. This technique entails applying local anesthesia to the mucosal membrane of the nasal cavity. In preparation for this procedure, a patient is placed flat on the back with the nose pointing directly upward. Lidocaine is the anesthetic that is typically administered with a cotton-tipped applicator to the nerve bundle within the lateral region of the nasal cavity. The applicator is typically left in this position for up to 30 minutes in order to enhance the absorption of the anesthetic. After the procedure, the patient will be monitored to assess the level of pain relief and the application may need to be repeated until the patient reports feeling significant relief.

An alternative approach involves administering an anesthetic without an applicator; typically a more viscous solution of lidocaine. The patient is positioned in the same manner as the transnasal approach and the patient is asked to quickly inhale while the solution is sprayed into the nasal passageway.

The third application technique, called the intraoral approach, is performed with a thin dental needle. Before the needle is inserted, the proper region in the gum line is located by the physician. After the correct position is identified, the needle is inserted into the gum line and the anesthetic is injected.

Patients typically begin to experience relief from the pain 15 to 30 minutes following the procedure. According to which technique is used, a patient may also need to be sedated to improve the level of comfort that is felt. Patients are also monitored in case harmful side effects begin to develop.

There is a low risk of complications associated with a sphenopalatine ganglion block and each of the approaches that can be utilized are minimally invasive. Furthermore, the effectiveness of this treatment method has been well researched. One study in particular showed that approximately 60% of the study participants who were suffering from cluster headaches and received a sphenopalatine ganglion block reported pain relief that persisted for up to six years. This form of treatment has also been supported through empirical research that demonstrates its effectiveness at relieving cancer-related pain.

Conditions Related to a Sphenopalatine Ganglion Block

Reports have demonstrated that sphenopalatine ganglion blocks effectively reduce or completely alleviate pain that is caused by cluster headaches, atypical face pain, and migraines. Previous research has also shown that this procedure successfully improves the symptoms of conditions that affect the parasympathetic system. When over-the-counter or prescription medications have been repeatedly ineffective at relieving pain, a sphenopalatine ganglion block may be the optimal form of treatment.

Conclusion

The sphenopalatine ganglion block is a non-surgical and minimally invasive treatment for individuals who are suffering from migraines, atypical face pain, and headaches. This form of treatment is often recommended for patients who have not experienced significant pain relief from taking medication or those who take pain relievers that causes serious side effects. The risks associated with a ganglion block are minimal and patients generally report experiencing almost immediate pain relief after the procedure. If the initial block is only slightly effective, individuals may undergo the procedure several additional times in order to enhance its effect.

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References

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  2. DeMaria S Jr, Govindaraj S, Chinosorvatana N, Kang S, Levine AI. Bilateral sphenopalatine ganglion blockade improves postoperative analgesia after endoscopic sinus surgery. Am J Rhinol Allergy. 2012;26(1):E23-7.
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