Sphenopalatine (SPG) Ganglion Block: Side Effects

Side effects of the Sphenopalatine Ganglion Block are almost always positive not negative. The most often cited effect is a feeling of calmness or peace. Many patients find that their tensions and anxiety drift away.
High blood pressure tends to stabilize and A-fib may improve.

Some patients describe an effect feeling energized and prefer to self administer after wakening while others feel a sense of calm and liketo do it in the evening prior to sleep.

While the SPG Block turns of the Sympathetic “Fight or Flight” reflex and turns on the Parasympathetic “Feed and Breed” or “Eat and Digest” reflex it does not seem to stimulate weight gain in fact in general has the opposite effect possibly by eliminating nervous or stress eating.

Women tend to have a positive effect on their libido , sometimes very soon after administration and some Aorgasmic women have reported developing normal or heightened sexual release.  More on the topic of Female libido and SPG Blocks.  https://www.sphenopalatineganglionblocks.com/sphenopalatine-ganglion-blocks-autonomic-blocks-answer-reduced-sexual-desire-self-administration-spg-blocks-key/

Most of the side effects are positive and their are literally hundreds of stories unexpected positive side effects. Frequently, I will use SPG Blocks on patients for their side effects. They seem to work to decrease phobias and can be used prior to flying, public speaking or other anxiety producing events.

Local side effects can vary by mode of administration. The Supra-Zygomatic injecton approach can rarely result in slight bruising but this is rare. Some patients have felt a very brief period of light headedness after a Supra-Zygomatic SPG Block.

The trans-nasal approach with the Sphenocath can allow anesthetic to drip into mouth or throat with bitter taste and temporary numbness. Occasionally, there can be slight nasal irritation or a speck of bleeding after use of Sphenocath. The cotton tipped nasal catheters will see this effect more often.

All SPG Blocks tend to increase sinus drainage initially but decrease chronic sinus issues over time. Chronic sinusitis/ rhinitis seem to improve over time in many patients.

The intra-oral injection can be uncomfortable when passing thru palatal tissues, this can be avoided with topical anesthetic followed by slow injection of just a drop or two of anesthetic and waiting for it to take effect before doing the injection through the greater palatine foramen.

All SPG techniques can cause numbness of the upper teeth, maxilla, cheeks and lips but i is rarely a problem. This is most likely to occur with the intra-oral approach.

Many of the side effects such as reduction of anxiety and/or depression are so common that SPG Blocks are given precisely for the side effects.

A recent discovery that may prove to be extremely important to millions of patients is that Sphenopalatine Ganglion Blocks eliminate Essentia Hypertension in about one third of patients.  A new article was published in 2018.

Comments 4

    1. Post
      Author
      ilshapira

      I am not sure what was done or why it was “on fire” It is normally not painful but if there is discomfort lidocaine spray can numb tissues before the block. Tight nasal passages are identified on a panoramic radiograph and Oxymetazoline is administered to shrink swollen membranes

  1. Julie

    My sinus cavity since SPG block has been in 10 times more pain than the normal trochlear headaches and pain from before. My neurologist denies it can hurt bc it’s lidocaine. What are the bad side effects of a SPG block and will this new pain subside?

    1. Post
      Author
      ilshapira

      Dr Shapira”s Response”
      Julie,
      It is extremely rare for the Sphenopalatine Ganglion Block to have any negative side effects and as your neurologist explained it only uses lidocaine. That said, the Neurologist is totally wrong in MHO telling you it can’t be related to the SPG Block. When a new pain arises one cannot assume it is/ or is not from the block and it may be an underlying or new condition that should be evaluated.

      There are headaches including vacuumn sinusitis and nasal contact headaches that theoretically could be a result of nasal irritation. Sphenopalatine Ganglion Blocks were originally discovered by an Otolaryngologist Greenfield Sluder MD who was chair of otolaryngology at Washington University of Medicine is St Louis. Typically Dentists and ENT’s are the experts on the Trigeminal nerve and referral patterns related to that nerve which includes teeth, gums,jaw muscles, jaw joints (TMJs), anterior 2/3 of tongue, lips lining of the sinuses (Maxillary, frontal and retro-orbital) and the cornea of the eye. Sluder’s textbook on Nasal Neurology is excellent for understanding the deeper aspects of the block.

      The first question was what was the method of application of the SPG Block. There are multiple methods of doing injections of the SPG either intra-oral or extra-oral which are amazingly effect for extremely severe pain quickly but carry minimal risks of injection.

      The use of a Sphenocath which is often used by neurologists or cotton-tipped catheters can both create minimal nasal irritation. When I teach self administration I will typically teach patients how to use Cotton-tipped catheter which gives continual delivery of lidocaie by capillary action across the membraneand it is done initially twice daily.

      A quick test for primary sinus pain due to infection or vacuumn sinusitis is to stand on tiptoes and drop onto heels with a thump. Primary sinus pain will briefly be acutely aggravate.

      In a tight nasal passage Afrin Nasal Spray(oxymetazoline) can reduce swelling in nasal tissue prior to administration of the block. Relieving Trochlear headache may uncover underlying issues that were always present. I often utilize SPG Blocks diagnostically to understand sources of pain.

      Ira L Shapira DDS, D,ABDSM, D,AAIPM, FICCMO, MICCMO
      Editor in Chief: CRANIO..Journal of Craniomandibular and Sleep Practice.
      Past Chair, Alliance of TMD Organizations
      Diplomat, Academy of Integrative Pain Management
      Diplomate, American Board of Dental Sleep Medicine
      Diplomate, American Board Sleep and Breathing
      Vice-President Regent, Master & Fellow, International College of CranioMandibular Orthopedics
      Board Eligible, American Academy of CranioFacial Pain
      Professor Neuromuscular Orthodontics and CranioMandibular Orthopedics University of Castellon
      Dental Section Editor, Sleep & Health Journal
      Past CranioFacial Pain Section Editor, CRANIO: Journal of Craniomandibular and Sleep Practice
      Member, American Equilibration Society

      Member, Academy of Applied Myofunctional Sciences
      Member, Academy of Cosmetic Dentistry
      Life Member, American Dental Association
      http://www.ThinkBetterLife.com
      http://www.DelanyDentalCare.com
      http://www.NorthShoreSleepDentist.com
      http://www.IHateCPAP.com
      http://www.iHateHeadaches.org
      http://www.SleepandHealth.com
      http://www.SphenopalatineGanglionBlocks.com
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