Analysis of the effectiveness of sphenopalatine ganglion block on fentanyl needs in endoscopic endonasal surgery as measured by qNOX score

Abstract

Introduction: Endoscopic endonasal is one of the technological advances used as a supporting examination for diagnosis and therapy. This procedure is often used to evaluate medical problems of the nose and sinuses, such as functional endoscopic sinus surgery or FESS (functional endoscopic sinus surgery), turbinoplasty, and septoplasty. Surgery can be difficult to manage because there is often bleeding due to the large supply of blood vessels in the sinus area. This study aimed to investigate differences in qNOX scores and fentanyl requirement in patients undergoing endoscopic endonasal surgery with sphenopalatine ganglion block. Methods: The total sample was 18 patients, with each treatment 9 patients. Patients were divided into two groups: group 1 patients who received sphenopalatine ganglion block with 0.75% ropivacaine and group 2 patients who did not receive a block. The selection of patients in groups 1 or 2 was done randomly (simple random) using lottery numbers and with a single blind. Result: Statistical analysis showed significant differences in intraoperatively in qNOX scores at the 5th, 10th, 15th and 20th minute and the mean qNOX score in the first 1 hour between the control group and the sphenopalatine ganglion block group. Significant differences were also found in fentanyl requirement between the control group and intraoperative sphenopalatine ganglion block, where fentanyl requirement was lower in the treatment group. Conclusion: The sphenopalatine ganglion block is a useful adjunct in patients undergoing endoscopic surgery and may reduce the need for fentanyl. In addition, it can provide a more stable qNOX score