Sphenopalatine Ganglion Blocks (SPG’s)
What is the Sphenopalatine Ganglion?
The sphenopalatine ganglion is the largest ganglion or collection of nerves in the head outside of the brain. It is located in the sphenopalatine fossa at the back of the nose.
What is the purpose of SPG’s?
This procedure is done for various pain conditions including headaches, nerve pain and muscular pain.
How is the block done?
The block is done while the patient is lying down on their back on an exam table. A long applicator wrapped in cotton at the end is dipped in 4% lidocaine and gently inserted into each nasal passageway. The applicator will remain in place for 15-30 minutes and is then removed.
How often is the block performed?
The block may be done once of multiple times over the course of several days as determined by your provider. When the block is done for chronic headaches; it is often done daily for five days in a row.
What will I feel during the procedure?
You may feel a slight discomfort as the applicator is inserted into the nasal passageway. It is common to experience tearing of the eyes during the procedure as well as an unpleasant taste in your mouth as the medication may drip down from the back of the nose. You may also feel numbness in the back of your throat.
When will I notice a change in my symptoms?
Some people may notice an improvement in their pain the first day of the procedure. When the blocks are being done over the course of several days over 50% of patients will experience an improvement in their pain by the third day of the procedure.
What are the risks of the procedure?
Risks such as bleeding, infection, drop in blood pressure, or allergy to lidocaine are rare. Blood pressure is monitored during the procedure. Sphenopalatine ganglion blocks are believed to be safe in pregnancy and in patients with various types of cancer such as brain tumors. They are also safe in patients who have pacemakers, defibrillators, spinal cord stimulators or metal implants.
Who should not have the procedure performed?
Please tell your provider if you have an allergy to any anesthetics (lidocaine, novacaine, marcaine or tetracaine) or if you have nasal polyps, a deviated nasal septum, or have had surgery on your face or sinuses.
How should I prepare for the procedure?
Your provider will ask you to purchase a bottle of over-the-counter Afrin nasal spray (solution, not gel) to bring with you each day of the procedure. Before the first procedure your provider will dilute the nasal spray by half with 4% lidocaine. This mixture will then be used prior to each procedure to anesthetize (numb) the nasal passageways.
Are there any restrictions before or after the procedure?
No, you may engage in your normal activities both before and after the procedure. There are no special restrictions unless you have been instructed otherwise by your provider.