Bilateral sphenopalatine ganglion block as adjuvant to general anaesthesia during endoscopic trans-nasal resection of pituitary adenoma | ||||
| Egyptian Journal of Anaesthesia | ||||
| Volume 26, Issue 4, October 2010, Page 273-280 PDF (601.98 K) | ||||
| DOI: 10.1016/j.egja.2010.05.002 | ||||
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| Authors | ||||
| Ashgan R. Ali; Sameh A. Sakr; Ahmed Shawky M.A. Rahman | ||||
| Abstract | ||||
| Background This study was conducted to investigate the anaesthetic, vasodilator, and post-operative analgesic sparing effect of bilateral sphenopalatine ganglion block (SPGB) in patients undergoing endoscopic endo-nasal trans-sphenoidal surgery. Methods Thirty adult patients of ASA (I, II), aged 20–60 years, were randomly allocated to either the block group or the non-block group ( = 15, for each). After establishment of general anesthesia with sevoflurane and 100% oxygen, the patients received bilateral SPGB with 1.5 ml of either 0.5% bupivacaine (block group) or 0.9% NaCl (non-block group). Intra-operative mean arterial pressure (MAP) was maintained at 60–65 mmHg by using nitroglycerine. End-tidal sevoflurane concentration required to maintain bispectral index values (40–50) throughout the operation was recorded. Nitroglycerine and propranolol consumption, blood loss, recovery profile, perioperative catecholamines, post-operative pain and meperidine consumption were evaluated. Results Block group showed significant decrease in sevoflurane and nitroglycerine consumption, blood loss, emergence time and time needed to achieve ⩾9 Aldrete score, < 0.0001. All patients in non-blockade group (100%) were supplemented by nitroglycerine to achieve the target MAP versus 9 patients (60%) in the block group ( < 0.01). Propranolol administration was necessary in 9 patients (60%) in the non-block group versus 3 patients (20%) in the block group, < 0.05. At PACU, visual analogue pain score and number of patients received meperidine analgesia were significantly less in the block group versus non-block group, < 0.0001 and < 0.001, respectively. Intra- and post-operative plasma epinephrine and nor-epinephrine levels were significantly higher in the non-block group than the block group, < 0.05. Conclusion Bilateral SPGB has anaesthetic, vasodilator and analgesic sparing effect when combined with general anaesthesia during endoscopic endo-nasal trans-sphenoidal resection of pituitary adenoma. | ||||
| Keywords | ||||
| Anaesthetic technique; regional; sphenopalatine ganglion | ||||
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