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Transnasal Sphenopalatine Ganglion Block
Aka: Transnasal Sphenopalatine Ganglion Block, Sphenopalatine Ganglion Block, Sphenopalatine Nerve Block
- See Also
- Emergency Department Migraine Headache Care
- Greater Occipital Nerve Block
- Indications
- Emergency Department Migraine Headache Care
- Contraindications
- Altered Mental Status
- Acute Head Trauma
- Bleeding Disorder or Anticoagulation (risk for difficult to control Epistaxis)
- Background
- Sphenopalatine Ganglion Block may be performed from several routes (oral, nasal, infratemporal)
- This approach is for a non-invasive transnasal approach
- Preparation
- Soak a long cotton applicator (long Q-Tip) in Topical Anesthetic
- Lidocaine 1-4% or
- Bupivicaine 0.5%
- Technique
- Patient lies with head elevated and with head in a sniffing position
- Insert the cotton swab (soaked with Topical Anesthetic) gently in the ipsilateral nare (side of the Headache)
- Continue to gently slide the swab along the nasal floor until it meets resistance
- Leave the swab in place for 5-10 minutes
- Remove the swab at no more than 10 minutes, and re-evaluate the patient
- Resources
- Sphenopalatine Ganglion Block for Treatment of Primary Headaches (ALiEM; Shih, MD)
- https://www.aliem.com/2017/03/trick-sphenopalatine-ganglion-block-primary-headaches/
- References
- Lin (2017) EM:Rap 17(11): 9-10