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Does Sphenopalatine Ganglion Block Improve Pain Control and Intraoperative Hemodynamics in Children Undergoing
Anantanarayanan Parameswaran1, Muruganand V Ganeshmurthy2, Yashoda Ashok3
1Professor, Department of Oral and Maxillofacial Surgery, Meenakshi Cleft and Craniofacial Centre, Chennai, India.
Insights
Sphenopalatine ganglion block (SPGB) significantly improves pain control and reduces blood loss in children undergoing cleft palate repair. This technique offers better perioperative analgesia and hemodynamic stability compared to general anesthesia alone.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Cleft palate repair in children often results in significant postoperative pain, dysphagia, and wound irritation.
- These complications can negatively impact surgical outcomes and patient recovery.
Purpose of the Study:
- To evaluate the efficacy of sphenopalatine ganglion block (SPGB) in improving intraoperative hemodynamics and postoperative analgesia.
- To assess SPGB's impact on children undergoing primary palatoplasty.
Main Methods:
- Prospective, double-blind, randomized controlled trial comparing SPGB with general anesthesia (GA) versus GA alone.
- 100 pediatric patients randomized; data collected on hemodynamics, pain scores, blood loss, and hematological parameters.
- Statistical analysis using independent-sample t test and Fisher exact test.
Main Results:
- SPGB group demonstrated significantly longer pain-free duration (87.59 min vs 19.46 min) and reduced blood loss (62 mL vs 105.5 mL).
- Improved surgical field quality and favorable postoperative changes in hemoglobin and packed cell volume were observed in the SPGB group.
- Statistically significant differences were noted for key outcome variables (P < .05).
Conclusions:
- Sphenopalatine ganglion block is an effective pre-emptive strategy for perioperative pain management in pediatric palatoplasty.
- SPGB provides excellent analgesia, hemodynamic stability, and a clearer surgical field.
- This technique optimizes the perioperative course for children undergoing cleft palate repair.
Purpose:
Children undergoing cleft palate repair have pain, dysphagia, and wound irritation in the immediate postoperative phase that may compromise surgical outcomes. This trial evaluates the efficacy of the sphenopalatine ganglion block (SPGB) in optimizing intraoperative hemodynamics and postoperative analgesia in children undergoing primary palatoplasty.
Materials And Methods:
The study was designed as a prospective, double-blind, randomized controlled trial comparing the use of SPGB with general anesthesia (GA) (study group) versus the use of only GA (control group). Routine preoperative documentation included type of cleft, patient weight, hemoglobin (Hb%), packed cell volume (PCV), blood pressure, and echocardiogram. Intraoperative monitoring included heart rate, blood pressure, and surgical field assessment. Postoperatively, the pain score, pain-free duration, and need for rescue analgesics were recorded. Postsurgical changes in Hb% and PCV values were assessed. Data analysis of collected variables was performed using SPSS software (version 16; IBM, Armonk, NY). Quantitative data were assessed for normality using the Shapiro-Wilk test and analyzed using the independent-sample t test, and the Fisher exact test was used for comparison of the binary variable (gender). The outcome variables were compared between the study and control groups after adjustment for confounding variables. P < .05 was considered statistically significant.
Results:
We randomized 100 patients undergoing primary palatoplasty under GA into the control group (n = 49) and study group (SPGB) (n = 51). Three patients were excluded from the control group because of changes in intraoperative anesthetic protocol. The results showed statistically significant differences in the postsurgical pain-free duration (19.46 minutes vs 87.59 minutes) and mean blood loss (105.5 mL vs 62 mL) in favor of the study group. Surgical field and postoperative reduction of Hb% and PCV were also significantly favorable for the study group.
Conclusions:
SPGB is a potent pre-emptive technique offering excellent perioperative analgesia, hemodynamic stability, and a clear surgical field.
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