This new article on Sphenopalatine Ganglion Blocks (SPGB) focuses on the use of SPG Blocks to prevent vomiting and nausea after endoscopic sinus surgery.  A more important question was left unaddressed will this work for vomiting and nausea related to chemotherapy or other disorders.  This could make a significant improvement in the life of patients going thru cancer treatment.  It should also be noted that it also reduced the number of vomiting episodes.  Frequent vomiting is extremely upsetting to patients who have recently had surgery, especially abdominal surgery.  An excellent study would be to evaluate the use of Sphenopalatine Ganglion Blocks (SPBG) a preventive for any surgery requiring general anesthetic.  The risk of aspirating vomit is substantial and if a simple SPG block could lower the risk it may be worthwhile to make SP_G Blocks a universal precaution for any surgery.

What if the “Miracle” blocks relieve nausea and vomiting relating to stomach flu or nausea and vomiting related to  general anesthetic.

It is interesting to note that this study looked at post operative nausea related to surgery for chronic rhinosinusitis.  It turns out that chronic vaso-rhinosinusitis is a condition that can be treated or relieved with SPG Blocks.

It is definitively worthwhile knowing that it is effective following sinus surgery because it is so easy for ENT’s to do this procedure while doing sinus procedures.

The most common uses of SPG block is to treat or prevent headaches, migraines, cluster headaches, sinus pain, sinus headaches, TMJ disorders, TMD and Autonomic Cephalgias.


Am J Rhinol Allergy. 2018 Jan 1:1945892418782235. doi: 10.1177/1945892418782235. [Epub ahead of print]

The Role of Endoscopic Sphenopalatine Ganglion Block on Nausea and Vomiting After Sinus Surgery.


Background Postoperative nausea and vomiting (PONV) are among the most common unpleasant and distressing adverse events following surgery under general anesthesia. Functional endoscopic sinus surgery (FESS) is a common otolaryngology procedure. Prevention of PONV and early recovery are cost-effective. Objective The aim of this study was to evaluate the prophylactic effect of bilateral endoscopic injection of lidocaine with epinephrine in the sphenopalatine ganglion (SPG) on PONV in patients undergoing FESS. Methods One hundred patients with chronic rhinosinusitis undergoing general anesthesia for FESS were enrolled in this double-blind, placebo-controlled study. Patients were randomized to receive injection of 2 mL of 2% lidocaine with epinephrine or 2 mL of saline at the end of surgery. Postoperatively, patients were observed for 24 h. PONV was evaluated immediately, 6 h, and 24 h after surgery. Results The 2 groups were comparable in characteristic and intraoperative features. In general, the incidence of PONV after FESS was 36%. The average time that patients can tolerate oral feeding was 3.4 h after surgery. Endoscopic SPG injection with lidocaine significantly reduced the incidence of vomiting and PONV. In addition, SPG injection with lidocaine reduced the incidence of severe vomiting and decreased the number of vomiting episodes. No complications were encountered in either group. Conclusion SPG injection with lidocaine at the end of surgery is a safe, noninvasive, and an effective technique in reducing early PONV in endoscopic sinus surgery patients.


complications; functional endoscopic sinus surgery; incidence; lidocaine; nausea; sphenopalatine ganglion block; vomiting

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