Sphenopalatine Plexus Block under General Anesthesia versus General Anesthesia Regarding Postoperative Pain Control in Functional Endoscopic Sinus Surgery (FESS)

Abstract

Abstract Background Functional endoscopic sinus surgery (FESS) is considered one of the most common surgical procedures. General anesthesia (GA) is usually required during FESS. Using regional analgesic techniques along with GA can be used to inhibit or decrease intra-operative and post-operative pain. Objective The aim of this work was to assess the effect of sphenopalatine plexus block in FESS using local anesthetics combined with general anesthesia to reduce use of pain killers postoperative. Methodology A prospective, randomized, single blinded comparative study conducted in the operating theatres of Ain Shams University Hospitals in a period of 6 months. Results Intra-operative vital data between Group 1(no SPGB) and Group 2(received SPGB) showed variations, with group 2 being more stable regarding blood pressure and heart rate. Moreover, post operatively Group 2 had lower VAS score readings and decreased no. of asking for rescue analgesia as compared to group 1. There was highly significant difference in systolic blood pressure between group 1 and group 2 with p value 0.00. There was highly significant difference between group 1 and group 2 regarding diastolic blood pressure with p value 0.00. There was a significant difference in heart rate, being higher in group 1 than group 2 intraoperative, on admission to PACU and 1 hour post-operative with p values 0.005 and 0. 010. There was a highly significant difference between group 1 and group 2 regarding VAS score on admission to PACU and after 1 hour post-operative with p value 0.003 and 0.009 respectively. There was a highly significant statistical difference in the number of doses of analgesia needed between group 1 and group 2 with p value 0.004. There was a highly statistically significant difference between group 1 and group 2 regarding 1st time analgesia was asked with p value 0.000. Conclusion Bilateral SPGB given intra-oral after induction of Anesthesia in FESS helps maintain patients vitally stable intraoperative as well as gives post- operative analgesia for patients at least 2 hours postoperatively with lower VAS score, and less number of doses of rescue analgesia needed post-operative, as compared to patients who didn’t receive local anesthesia along with General anesthesia.