If you suffer from persistent and chronic facial pain or headaches, you may benefit from a sphenopalatine ganglion nerve block. This procedure is used for patients who do not respond to conventional measures. The block is a minimally invasive injection that treats a variety of pain syndromes.
What conditions are treated using the sphenopalatine ganglion block procedure?
The sphenopalatine ganglion block is used to treat:
- Cluster headaches
- Trigeminal neuralgia
- Migraine headaches
- Cancer pain of the neck, head, and face
- Mouth and tongue pain
- Atypical facial pain
- Sluder’s neuralgia
- Temporomandibular joint (TMJ) pain
- Paroxysmal hemicrania
- Herpes zoster
- Vasomotor rhinitis
- Reflex sympathetic dystrophy
- Post-traumatic headache
What are the benefits of the sphenopalatine ganglion block?
The sphenopalatine ganglion block is an effective, safe procedure for refractory face and head pain. It is minimally invasive, requires no overnight stay, and does not involve general anesthesia. In addition, the block is used when the patient does not respond to medications and other head/face pain measures.
Are there any preparations before the sphenopalatine ganglion block?
Before you undergo the block, you will first meet with the pain management specialist who evaluates your condition. The Annapolis pain doctor may perform some imaging tests, take a medical history, and conduct a physical examination. Before the procedure, the doctor reviews the risks and benefits with you and has you sign a consent form. When you arrive at the medical facility, a nurse has you change into a procedure gown, places an IV line in your arm, and positions you in a semi-lying position on the procedure table.
What happens during the sphenopalatine ganglion block procedure?
The block involves instilling an anesthetic and/or neurolytic agent onto the nerves. After you are given a sedative, 
the block is done by one of three approaches: intranasal, infrazygomatic, and transoral. With the intranasal approach, the nasal passage is numbed with a lubricated cotton-tipped applicator soaked with lidocaine.
After 30 minutes, a catheter is inserted, and the numbing agent is instilled onto the nerves. After several minutes, the catheter is removed. Signs of a successful block include nasal congestion and tearing.
Are there other approaches to this procedure?
The transoral approach to the sphenopalatine ganglion block involves passing a needle through the top of the hard palate inside the mouth. This approach is painful and technically difficult, so it is rarely used. In addition, the lateral infratemporal approach involves inserting the cannula through the facial area via a tiny needle. The needle is then removed, and the medication is injected through the cannula. Sometimes, a series of 3 blocks are done, spaced 1-4 weeks apart.
What can I expect after the sphenopalatine ganglion block?
After the block, you are monitored by a nurse in the recovery area for 30-60 minutes. As you awake from sedation, you may feel warmth on the side of your face, have some eye redness, and maybe eye drooping. These are temporary side effects that resolve quickly. Because a sedative was given, you should not drive for 24 hours. In addition, we recommend resting for 2-3 days. You may have immediate pain relief after the block, but pain can return. When neurolysis is done, the full results are felt 2-3 days after the procedure.
Does the sphenopalatine ganglion block work?
In a 2005 study, 30 patients with chronic facial and head pain were treated using the sphenopalatine ganglion block using radiofrequency energy to destroy the nerves. In the study, the efficacy rate was 86%.
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