• Regional anesthesia · Nov 1993

    Randomized Controlled Trial Clinical Trial

    Lack of effect of sphenopalatine ganglion block with intranasal lidocaine on submaximal effort tourniquet test pain.

    • D G Silverman, R F Spencer, L M Kitahata, and T Z O'Connor.
    • Center for Pain Management, Yale University School of Medicine, New Haven, Connecticut 06510.
    • Reg Anesth. 1993 Nov 1; 18 (6): 356-60.

    Background And ObjectivesThe present study examined whether sphenopalatine ganglion block (SPGB) causes a reduction in the response to acute nociceptive input that may account for the SPGB-induced relief reported by many patients with chronic pain.MethodsIn a double-blind, crossover design, 16 healthy volunteers underwent separate 15-minute submaximal effort tourniquet tests before and after SPGB with 20% lidocaine plus 1:100,000 epinephrine (SPGBlidocaine) or placebo (SPGBsaline). Responses during each minute of tourniquet inflation were converted to a 1 to 16 scale and classified as nothing (1), mild sensation (2-4), strong sensation (5-7), slightly painful (8-10), definitely painful (11-13), and severely painful (14-16).ResultsMaximum pain scores reached 12.6 +/- 2.5 (mean +/- SD) pre-SPGB, 10.9 +/- 3.5 after SPGBsaline, and 11.1 +/- 2.5 after SPGBlidocaine. No significant differences were noted between SPGBlidocaine and SPGBsaline at any of the 15 time points (p = NS by repeated measures ANOVA and paired t-test). However, retrospective grouping of time points noted that scores after SPGBlidocaine were lower in the "strong sensation" range.ConclusionSPGB does not lessen acute extremity pain to a significant degree and is not in and of itself an effective means of analgesia for acute pain. Its potential impact on nociceptive stimuli that elicit a "strong sensation" (i.e., a score of 5-7 in the present study) should be evaluated in hyperpathic pain states and in states with exaggerated aversive responses.

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