Effect of Sphenopalatine Ganglion Nerve Block on Bleeding and Pain During and After Rhinoplasty and Septoplasty Surgeries: A Double-Blind Randomized Clinical Trial

Abstract

Background: The sphenopalatine ganglion nerve block (SPGB) in endoscopic sinus surgeries has been shown to reduce postsurgery narcotic consumption. Objectives: This study aimed to investigate the effect of SPGB on bleeding and pain during and after rhinoplasty and septoplasty. Methods: This study was conducted as a double-blind, randomized clinical trial and included 30 patients who were scheduled for elective rhinoplasty and septoplasty. All the participants received propofol/remifentanil anesthesia and similar intraoperative care. The patients were divided into 2 groups: the SPGB group, which received 0.5% bupivacaine, and the placebo group, which received normal saline. The study compared the amount of narcotics used during and after the operation, pain levels during and after the operation (at 2, 4, 6, and 24 hours after the operation), and bleeding during the operation between the 2 groups. The surgeon's satisfaction with bleeding control was also recorded at 30, 60, and 90 minutes. Results: In the SPGB group, 86% of the participants had ASA (American Society of Anesthesiologists) class I, while in the placebo group, 80% had ASA class I. There was no significant difference in postoperative pain between the control and intervention groups (P > 0.05). However, the SPGB group showed a significant decrease in intraoperative pain based on the amount of narcotics received (P < 0.05). According to the Boezaart criterion, the control group had significantly higher rates of severe and moderate bleeding (P < 0.05), whereas the bupivacaine group had a lower total bleeding rate (P < 0.05). Conclusions: The administration of bupivacaine was effective in reducing pain, bleeding, and the need for narcotics during surgery. The SPGB has the potential to decrease bleeding and drug utilization, making it a preferable option for anesthesiologists aiming to minimize the use of anesthetics.