Evaluation of the efficacy of bilateral sphenopalatine ganglion block in endoscopic sinus surgery under general anesthesia: a randomized prospective controlled trial

Abstract

Background The major problem of functional endoscopic sinus surgery is impaired visibility of the surgical field due to excessive bleeding. Although controlled hypotension has been used to minimize intraoperative blood loss, it may invite several problems. To avoid these complications, this randomized controlled study was designed to evaluate the efficacy of bilateral sphenopalatine ganglion block (SPGB) under general anaesthesia, which could provide better hemodynamic parameters, good surgical condition, decreased blood loss, rapid recovery, better postoperative pain control and fewer complications during functional endoscopic sinus surgery. Patients and methods Sixty adult patients of both sexes between 15 and 55 years of age of American Society of Anaesthesiologists Physical Status I–II were randomly allocated into two equal groups. Group A patients received bilateral SPGB with 2.5 ml of 0.25% levobupivacaine on each side after induction of general anaesthesia. Group B patients received only general anaesthesia. Baseline and intraoperative heart rate, mean arterial blood pressure, oxygen saturation, end tidal carbon dioxide, temperature and blood loss were recorded. Surgical field, recovery score and postoperative pain were assessed using the average category scale, Aldrete recovery score and the visual analogue scale, respectively. The time to first rescue analgesic was noted. Results Intraoperative mean arterial blood pressure, heart rate, blood loss, average category scale and postoperative visual analogue scale were significantly lower in the block group compared with the control group. Aldrete recovery score was significantly higher in the block group compared with the control group. First rescue analgesic requirement was delayed in the block group compared with the control group. Conclusion SPGB is effective for providing better haemodynamic control, good surgical field, lesser blood loss, early recovery and prolonged postoperative analgesia in this surgery.