The sphenopalatine ganglion block is used to diagnose the source of face and/or head pain. In addition, it is a useful therapeutic treatment for many painful conditions. The procedure involves using a long-acting anesthetic or a neurolytic agent to block pain signals.
What is the sphenopalatine ganglion?
The sphenopalatine ganglion is a collection of nerves found at the back of the throat below the nose. These nerves contain sympathetic parasympathetic, and sensory roots, and supply the lacrimal gland, paranasal sinuses, mucosa glands, and the nasal cavity. The nerve fiber is sensitized by trauma or infection. Anesthetizing these nerves will often eliminate pain.
What conditions are treated with the sphenopalatine ganglion block?
- Temporomandibular joint pain
- Trigeminal neuralgia
- Sluder’s nerualgia
- Head and neck cancer pain
- Paroxysmal hemicranias
- Herpes zoster pain
- Complex regional pain syndrome
How do I prepare for the procedure?
Before the block, the doctor will discuss the risks and benefits with you and have you sign a form of consent. You should not eat or drink after midnight the day of the procedure, but are permitted to take medicines with small sips of water. You will be given a mild sedative, so bring someone with you to provide a ride home. When you get to the pain center, a nurse will place an IV catheter in your arm to administer medications.
How is the sphenopalatine ganglion block performed?
There are three approaches used to perform the sphenopalatine ganglion block: the transnasal (through the nose), the transoral (through the mouth), and the lateral (through the neck). The most common is the transnasal approach.
The doctor will anesthetize the nostril with a 2% lidocaine gel solution on a cotton applicator, which remains in position for 20-30 minutes. Then, he/she will insert a catheter, using x-ray guidance. Some contrast fluid may be injected to enable the doctor to see the catheter and to assure it is near the nerve bundle. Once in place, the medication is instilled onto the nerve mass. The entire procedure takes around 15-30 minutes to perform.
Will the doctor use electrical current during the block?
The doctor may choose to administer either radiofrequency (RF) electric current or pulsed radiofrequency (PRF) electrical current to destroy the nerve root.
What can I expect after the sphenopalatine block?
Once the procedure is finished, you will be moved to a recovery area where a nurse will monitor your condition. Once you are stable, you are given some discharge instructions. We recommend that you take it easy for the remainder of the day and gradually return to normal activities as tolerated. You are allowed to eat and drink following the procedure, but should not drive for 24 hours.
What are the risks and complications associated with the sphenopalatine block?
The risks and complications associated with this procedure are rare, but they can occur. These include nosebleed, allergic reaction, infection, and seizure. In addition, there are a few side effects, such as a bitter taste in the mouth and a warm sensation along the neck and face.
What is the success rate of the sphenopalatine ganglion block?
The use of the sphenopalatine ganglion block has been studied for years, and its effectiveness is well-supported. In one study, the block was used to treat cluster headaches, and more than 60% of the participants reported ongoing benefits for years after the procedure. In another study, 88% of patients achieved good control of cancer-related pain with the block.
The Board Certified pain doctors at Colorado Clinic offer SPG blocks for all types of head and facial pain conditions. There are 3 convenient Northern Colorado locations including Boulder, Greeley and Loveland. Call us today!
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Leong MS, Gjolaij MP, Gaeta RR. Sphenopalatine Ganglion Block. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. 2013, pp. 303-307.
Levin M. Nerve blocks and nerve stimulation in headache disorders. Tech Reg Anesthesia & Pain Management. 2009;13:42-49.
Varghese BT, Koshy RC. Endoscopic transnasal neurolytic sphenopalatine ganglion block for head and neck cancer pain. J Laryngol Otol. 2001 May;115(5):385-7.