Facial Temperature Changes Following Intranasal Sphenopalatine Ganglion Nerve Block

Ronald A. Wasserman, Trevor Schack, Stephanie E. Moser, Chad M. Brummett, Wade Cooper

Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA

Objectives: To determine whether a facial temperature change occurs following lidocaine delivery to the sphenopalatine foramen via an intranasal catheter.

Background: Intranasal SPG blockade has received renewed interest with the advent of intranasal catheters that direct medication to the sphenopalatine foramen to achieve neural blockade. However, it is unclear whether such procedures have a measurable effect on cranial autonomic function. To date there have been no published reports of cranial autonomic nervous system effect via temperature change from intranasal SPG block procedures.

Methods: This was a retrospective analysis of 47 patients with a diagnosis of chronic head or facial pain who underwent intranasal sphenopalatine ganglion (SPG) blockade. Facial temperatures were monitored using skin temperature probes over the ipsilateral zygoma and recorded pre-procedure and 15 minutes post-procedure.

Results: 47 patients were included. The average temperature change was an increase of +1.4 °C which was statistically significant (p<0.001) and 50% of patients had a 1 °C or higher temperature change.

Conclusion:  This study is the first to show a statistically significant increase in temperature following intranasal SPG block. This suggests that delivery of anesthetic to the sphenopalatine foramen results in blockade of the sympathetic fiber activity possibly via the maxillary artery plexus branches surrounding the sphenopalatine foramen prior to parasympathetic activity in the SPG. Journal of Nature and Science (JNSCI), 3(5):e354, 2017

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