Transnasal Sphenopalatine Ganglion Block

Aka: Transnasal Sphenopalatine Ganglion Block, Sphenopalatine Ganglion Block, Sphenopalatine Nerve Block

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II. Indications

  1. Emergency Department Migraine Headache Care

III. Contraindications

  1. Altered Mental Status
  2. Acute Head Trauma
  3. Bleeding Disorder or Anticoagulation (risk for difficult to control Epistaxis)

IV. Background

  1. Sphenopalatine Ganglion Block may be performed from several routes (oral, nasal, infratemporal)
  2. This approach is for a non-invasive transnasal approach

V. Preparation

  1. Soak a long cotton applicator (long Q-Tip) in Topical Anesthetic
    1. Lidocaine 1-4% or
    2. Bupivicaine 0.5%

VI. Technique

  1. Patient lies with head elevated and with head in a sniffing position
  2. Insert the cotton swab (soaked with Topical Anesthetic) gently in the ipsilateral nare (side of the Headache)
    1. Continue to gently slide the swab along the nasal floor until it meets resistance
  3. Leave the swab in place for 5-10 minutes
  4. Remove the swab at no more than 10 minutes, and re-evaluate the patient

VII. Resources

  1. Sphenopalatine Ganglion Block for Treatment of Primary Headaches (ALiEM; Shih, MD)
    1. https://www.aliem.com/2017/03/trick-sphenopalatine-ganglion-block-primary-headaches/

VIII. References

  1. Lin (2017) EM:Rap 17(11): 9-10

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Related Studies

Ontology: Sphenopalatine Ganglion Block (C0394799)

Definition (MSH) Method of treating pain associated with the sphenopalatine ganglion located in the PTERYGOPALATINE FOSSA, posterior to the middle nasal turbinate. The transnasal approach involves application of suitable local anesthetic to the mucous membrane overlying the ganglion.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D059387
SnomedCT 86169007
CPT 64505
English Injection, anesthetic agent; sphenopalatine ganglion, Loc anaes sphenopal gang block, N BLOCK SPENOPALATINE GANGL, N block spenopalatine gangl, Sphenopalatine Ganglion Block, Blocks, Sphenopalatine Ganglion, Block, Pterygopalatine Ganglion, Ganglion Blocks, Sphenopalatine, Pterygopalatine Ganglion Block, Blocks, Pterygopalatine Ganglion, Block, Sphenopalatine Ganglion, Ganglion Blocks, Pterygopalatine, Pterygopalatine Ganglion Blocks, Ganglion Block, Sphenopalatine, Sphenopalatine Ganglion Blocks, Ganglion Block, Pterygopalatine, INJECTION ANES AGENT SPHENOPALATINE GANGLION, Injection of anesthetic agent into sphenopalatine ganglion, Injection of anaesthetic agent into sphenopalatine ganglion, Sphenopalatine ganglion block, Local anaesthetic sphenopalatine ganglion block, Local anesthetic sphenopalatine ganglion block, Injection of anesthetic agent into sphenopalatine ganglion (procedure)
Spanish inyección de agente anestésico en ganglio esfenopalatino (procedimiento), inyección de agente anestésico en ganglio esfenopalatino, inyección de un agente anestésico en el ganglio esfenopalatino, inyección de un agente anestésico en el ganglio esfenopalatino (procedimiento), Bloqueo del Ganglio Esfenopalatino
French Blocage du ganglion sphénopalatin, Blocage du ganglion ptérygopalatin
Portuguese Bloqueio do Gânglio Esfenopalatino
Russian КРЫЛОНЕБНОГО ГАНГЛИЯ БЛОКАДА, ОСНОВНО-НЕБНОГО ГАНГЛИЯ БЛОКАДА, OSNOVNO-NEBNOGO GANGLIIA BLOKADA, KRYLONEBNOGO GANGLIIA BLOKADA, ОСНОВНО-НЕБНАЯ ГАНГЛИОНАРНАЯ БЛОКАДА, OSNOVNO-NEBNAIA GANGLIONARNAIA BLOKADA
Czech blokáda ganglion pterygopalatinum
Polish Blokada zwoju skrzydłowo-podniebiennego
Italian Blocco del ganglio sfenopalatino
German Ganglion sphenopalatinum-Blockade, Meckel Ganglion-Blockade, Ganglion sphenopalatinum, Blockade des, Ganglion pterygopalatinum, Blockade des, Ganglion pterygopalatinum-Blockade, Meckel Ganglion, Blockade des
Norwegian Blokade av ganglion sphenopalatinum, Blokade av ganglion pterygopalatinum
Derived from the NIH UMLS (Unified Medical Language System)

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