Trans-nasal Sphenopalatine Ganglion Block for Prevention of Emergence Agitation Following Functional Endoscopic Sinus Surgery (SPGB-EA)
Effect of Bilateral Trans-nasal Sphenopalatine Ganglion Block on Emergence Agitation Following Functional Endoscopic Sinus Surgery: A Double-Blind Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Dakahlia Governorate
-
Al Mansurah, Dakahlia Governorate, Egypt
- Mansoura University Hospitals
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria
- Age 18-65 years.
- ASA physical status I-II.
- Scheduled for elective FESS under general anesthesia.
- Ability to provide informed consent. Exclusion Criteria
- ASA physical status III or higher.
- Known allergy or contraindication to local anesthetics.
- Coagulopathy or anticoagulant therapy.
- Psychiatric illness or cognitive impairment affecting agitation assessment.
- Chronic opioid use or substance abuse.
- Pregnancy or lactation.
- Revision nasal surgery or anatomical abnormalities preventing SPGB.
- Intraoperative complications requiring deviation from the study protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental Group (SPGB)
Bilateral trans-nasal SPGB performed under direct endoscopic visualization using 1.5 mL of 0.5% bupivacaine per side.
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Bilateral trans-nasal sphenopalatine ganglion block performed under direct endoscopic visualization using 1.5 mL of 0.5% bupivacaine per side.
Other Names:
|
|
Placebo Comparator: Placebo Comparator Group (C)
Bilateral trans-nasal sham injection performed under direct endoscopic visualization using 1.5 mL normal saline per side.
|
Bilateral trans-nasal sham injection performed under direct endoscopic visualization using 1.5 mL of normal saline per side.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Emergence Agitation
Time Frame: first 30 minutes in the post-anesthesia care unit (PACU).
|
Incidence of emergence agitation, defined as a Richmond Agitation-Sedation Scale (RASS) score ≥ +2 at any time during the first 30 minutes in the post-anesthesia care unit (PACU).
|
first 30 minutes in the post-anesthesia care unit (PACU).
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative Pain Scores
Time Frame: first 30 minutes in the post-anesthesia care unit (PACU)
|
Pain intensity assessed using the Visual Analog Scale (VAS).
|
first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Postoperative Fentanyl Consumption
Time Frame: first 30 minutes in the post-anesthesia care unit (PACU)
|
Total postoperative fentanyl requirement administered for rescue analgesia.
|
first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Mean Arterial Blood Pressure
Time Frame: From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
Intraoperative and postoperative mean arterial blood pressure measurements.
|
From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Heart Rate
Time Frame: From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
Intraoperative and postoperative heart rate measurements.
|
From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Incidence of Postoperative Nausea and Vomiting
Time Frame: first 30 minutes in the post-anesthesia care unit (PACU)
|
Occurrence of postoperative nausea and/or vomiting.
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first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Adverse Events
Time Frame: From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
Procedure-related complications including epistaxis, local anesthetic systemic toxicity, diplopia or visual symptoms, palatal numbness, and other adverse events.
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From induction of anesthesia until first 30 minutes in the post-anesthesia care unit (PACU)
|
|
Duration of Surgery
Time Frame: During surgery
|
Total operative time measured from surgical incision to completion of surgery.
|
During surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Amir Mostafa Shabana, MD, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Publications and helpful links
General Publications
- Kesimci E, Ozturk L, Bercin S, Kiris M, Eldem A, Kanbak O. Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2012 Jan;269(1):165-9. doi: 10.1007/s00405-011-1702-z. Epub 2011 Jul 8.
- Kim DH, Kang H, Hwang SH. The Effect of Sphenopalatine Block on the Postoperative Pain of Endoscopic Sinus Surgery: A Meta-analysis. Otolaryngol Head Neck Surg. 2019 Feb;160(2):223-231. doi: 10.1177/0194599818805673. Epub 2018 Oct 9.
- Wang P. The efficacy of sphenopalatine ganglion block for pain management after endoscopic sinus surgery: a meta-analysis of randomized controlled studies. Eur Arch Otorhinolaryngol. 2021 Aug;278(8):2681-2687. doi: 10.1007/s00405-020-06484-9. Epub 2021 Jan 3.
- Hamed R, Gamal L, Elsawy S, Baker MA, Abbas YH. Efficacy of ultrasound guided sphenopalatine ganglion block in management of emergence agitation after sinoscopic nasal surgery: a randomized double-blind controlled study. Anaesth Crit Care Pain Med. 2024 Dec;43(6):101429. doi: 10.1016/j.accpm.2024.101429. Epub 2024 Oct 2.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- ANES-FESS-SPGB-2026-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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