Intra-oral Sphenopalatine Ganglion Block for Pain Control After Nasal Surgery. Sinus Headaches and Migraine Treatment

This abstract(below) from a Russian Journal discusses utilizing
Sphenopalatine Ganglion Blocks for pain control after nasal surgery. This block is also excellent for treating migraines and cluster headaches.
For many years I used only the intra-oral palatal injection but today my first choice for injection is the Suprazygomatic Approach to the SPG Block.

While injection therapy is rapid and effective relief of acute pain it is not always the best approach for chronic pain. My preferred approach for migraine, cluster headache, tension headache and TMJ disorders is self administered SPG blocks with cotton tippped nasal catheters that offer continual capillary feed.

This is both economical and efficient. Patient can self-administer as needed without hospital or doctor visits.

This same approach of an intra-oral block of the Sphenopalatine Ganglion has also been show to be effective at treating
Trigeminal Neuralgia (abstract below)”Evaluation of sphenopalatine ganglion blockade via intra oral route for the management of atypical trigeminal neuralgia.”

The same approach of using injection for acute trigeminal neuralgia but self administered transnasal blocks for long term management applies. For Chronic pain self administration is key. Self administration has been used successfully in patients with cancer pain as well.

Learn more at

Dr Shapira teaches patients to self administer SPG Blocks.

Dr Shapira’s Website:

Patient videos at:

Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences

Vestn Otorinolaringol. 2016;81(4):38-41. doi: 10.17116/otorino201681438-41.
[The blockade of sphenopalatineganglionthrough the palatal approachin the present-day rhinological practice].
[Article in Russian; Abstract available in Russian from the publisher]
Borodulin VG1, Filimonov SV1.
Author information
Abstractin English, Russian
This article deals with the application of the sphenopalatine ganglion blockade in the present-day rhinological practice. The blockade is known to arrest the propagation of pain impulses from the nose and break the rhinocardiac reflex arc. Moreover, it is involved in bleeding control during nasal surgery. The method for the blockade via the palatal route using the modern equipment and imaging techniques is described. The objective of the present study was to evaluate the effectiveness and safety of the blockade of sphenopalatine ganglionthrough the palatal approach in the patients who had undergone septoplasty under general and local anesthesia. It included a total of 105 patients divided into two groups one of which was treated with the use ofblockade of sphenopalatineganglionin addition to conventional anesthesia while the patients of the other group were treated under traditional anesthesia alone. The results of the study confirm the effectiveness of blockade of sphenopalatineganglionthrough the palatal approach as a method for the treatment of postoperative syndrome, bleeding control during nasal surgery, and reduction of parasympathetic influence on the cardiac rhythm.
PMID: 27500577

Springerplus. 2016 Jun 27;5(1):906. doi: 10.1186/s40064-016-2612-8. eCollection 2016.
Evaluation of sphenopalatine ganglion blockade via intra oral route for the management of atypical trigeminal neuralgia.
Coven I1, Dayısoylu EH2.
Author information
The sphenopalatine ganglion (SPG) may be involved in persistent idiopathic facial pain and unilateral headaches. The role of SPG blockade via intra oral route in the management of trigeminal neuralgia (TN) is worthy of study.
In this retrospective study, patient records included patients with atypical TN (type 2) that persisted in spite of conservative treatment for at least 2 years, and an average pain intensity from the craniofacial region visual analogue scale (VAS) before examination. In group I the patients received carmapazepin 800 mg a day for at least 2 years. In group II 3 ml of local anesthetic agent consisting 2 ml bupivacaine and 1 ml prilocain in addition to 1 ml fentanyl, 0.5 ml betametasone disodium phosphate and 0.5 ml opaque was injected by the intraoral route. In this group, injection procedures were performed under local anesthesia with fluoroscopic guidance. The Kruskal-Wallis and Mann-Whitney U tests with Bonferroni correction were used for intergroup analysis. Age and sex differences were evaluated with one-way ANOVA and Fisher’s exact tests, respectively.
Significant differences were found between pre-op and 3rd day VAS values and also pre-op and 1st month VAS values. No significant differences were found between pre-op and 6th month VAS values.
The SPG blockade improves the quality of life of patients and a minimally-invasive procedure to management of TN, when compared to other methods.
PMID: 27386351 PMCID: PMC4923019 DOI: 10.1186/s40064-016-2612-8

Leave a Reply

Your email address will not be published. Required fields are marked *