• Helen Triantafyllidi, Chrysa Arvaniti, Antonios Schoinas, Dimitris Benas, Stefanos Vlachos, Leonidas Palaiodimos, George Pavlidis, Ignatios Ikonomidis, Chrysanthi Batistaki, Costas Voumvourakis, and John Lekakis.
• 2nd Cardiology Department, Medical School, University of Athens, ATTIKON Hospital, Athens, Greece. Electronic address: seliani@hotmail.com.
• Int. J. Cardiol. 2018 Jan 1; 250: 233-239.

BackgroundSympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension.MethodsWe performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48±12years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51±12years, 8 men). All patients have been subjected to 24h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24h SBP decrease ≥5mmHg.ResultsWe found that 24h and daytime DBP (p=0.02) as well as daytime DBP load (p=0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24h and daytime (p<0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group.ConclusionsSPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.Copyright © 2017 Elsevier B.V. All rights reserved.

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