Blocking Sphenopalatine Ganglion by Intranasal Lidocaine Spray in Partial Turbinectomy Surgeries
Efficacy of Intranasal Sphenopalatine Ganglion Block by Lidocaine Spray for Partial Turbinectomy Surgeries
Ain Shams University
50 participants
Dec 20, 2025
INTERVENTIONAL
Conditions
Summary
Nasal turbinectomy surgeries are usually done as day case surgeries as most patients are young with unremarkable comorbidities. However, considerations are still present towards patients of old age or those suffering from obesity or obstructive sleep apnea (OSA). Different techniques are still evolving to improve handling those patients to decrease complications, enhance recovery after surgery and increase patient satisfaction. Targeting sphenopalatine ganglion block by topical local anesthesia is a proposed technique that could help by decreasing peri-operative opioid consumption.
Eligibility
Inclusion Criteria2
- Undergoing elective partial turbinectomy surgery
- Age 18 years or older
Exclusion Criteria5
- Patient refusal
- Kidney or liver impairment
- Pregnant or breast-feeding women
- Allergy to any of the drugs used in the study
- OR time more than 90 minutes (defined as time from anaesthesia induction to end of surgery, excluding extubation time)
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Interventions
Standardized general anaesthesia with fentanyl 2 mcg/kg ABW at induction, propofol 1.5 mg/kg, rocuronium 0.6 mg/kg, sevoflurane 1 MAC for maintenance, followed by morphine 0.05 mg/kg ABW after intubation and nasal decongestant application. Intraoperative rescue fentanyl 50 mcg IV for tachycardia or hypertension exceeding 20% above baseline, repeatable after 10 minutes. Postoperative paracetamol 1g IV every 8 hours and pethidine 50 mg IV for VAS greater than 4.
Identical general anaesthesia induction and maintenance as the control arm. After intubation and bilateral xylometazoline nasal decongestant: intranasal lidocaine 10% spray 10 puffs per nostril bilaterally, directed parallel to the nasal floor in a postero-superior direction until resistance is felt, targeting the sphenopalatine fossa. Total dose not to exceed 3 mg/kg ABW. Identical rescue and postoperative analgesia as control arm.
Locations(1)
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NCT07299630