Self administration of Sphenopalatine ganglion block for head and

Self administration of
Sphenopalatine ganglion
block for head and neck
cancer pain management
Dr Priti R Sanghavi
P r o f e s s o r, D e p t o f A n e s t h e s i o l o g y
Gujarat Cancer And Research Institute
Ahmedabad
Outline
→ Introduction
→ Why and for whom?
→ How to perform?
→ Results
→ Why it is so effective?
→ Conclusion
→ References
Why and for whom?
•
•
To provide pain relief at home
Inclusion criteria
as well as quality of life
• Severe to worst
• Bleeding
pain
tendency
• Not controlled by • Nasal obstruction
opioids
• Good effect of
SPGB
• Literate patient
Pt who
understand
• Patient
willingness
to observe ease of
performance and
effectiveness
•
to make palliative care
practitioner aware of this method
of pain relief
Exclusion criteria
NOTE: Intensity of pain (NRS) and Quality of life with EORTC QLQ –H&N 35
Associated symptoms
How to perform?
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◦ Second level
◦ Third level
◦ Fourth level
◦ Fifth level
Self administration video
2/13/2015
4
Results
•
Ease of performance :- 16/19 Patients
•
Duration of analgesia :- 8 hrs – 7 days
•
Frequency of procedure:–
11 Pt: Weekly
–
2 pt: alternate day
–
2 pt: Once a day
–
1 pt: three times a day
•
Intensity of pain NRS score:–
Immediate : 8.566+/-1.05 to 2.456+/-1.234
–
After 1 month : 8.566+/-1.05 to 6.211+/-1.3
•
Quality of life (EORTC QLQ –H&N 35) :- Mean pain score and Feeling of sick were decreased post SPGB
•
Associated symptoms:- Sleep disturbance is relived in all patients
Why it is so effective?
Conclusion
• Self administration of SPG Block is relatively easy and safe
method of control of acute and chronic pain in H&N cancer pt
• Can be performed bilaterally, repeatedly
• Can be performed in presence of RT
• Outpatient procedure
• Can be safely taught to effectively perform at home with good
expectations and results
References
1. Saade, E., and G. B. Paige. "Patient-administered sphenopalatine ganglion
block." Regional anesthesia 21.1 (1996): 68.
2. Peterson, Jerome N., et al. "Sphenopalatine ganglion block: a safe and
easy method for the management of orofacial pain." Cranio: the journal of
craniomandibular practice 13.3 (1995): 177-181.
THANK YOU
Thanks to ENT surgeon, Neuro-onco surgeon for their support
and guidance