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Sphenopalatine Ganglion Block as Adjuvant to General Anesthesia Regarding the Quality of Surgical Field in Trans-Sphenoidal Endoscopic Hypophysectomy

2026年4月29日 更新者：Nada Ashraf Mohamed Fathy、Cairo University

The Efficacy of Ultrasound Guided Sphenopalatine Ganglion Block as Adjuvant to General Anesthesia Regarding the Quality of Surgical Field in Trans-Sphenoidal Endoscopic Hypophysectomy: A Randomized Controlled Trial

This study aims to evaluate the efficacy of ultrasound guided sphenopalatine ganglion block (SPGB) through the suprazygomatic approach in optimizing the quality of surgical field as well as its effect on postoperative pain relief in patients undergoing transsphenoidal pituitary surgeries under general anesthesia.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

The main surgical treatment for pituitary adenomas is endoscopic trans-sphenoidal hypophysectomy.

Among the many regional blocks used is the sphenopalatine ganglion block (SPGB). It is one of the parasympathetic ganglia in the head, located in the pterygopalatine fossa, posterior to the middle nasal turbinate, 1-5 mm deep to the mucosa, anterior to the pterygoid canal and lateral to the sphenopalatine foramen.

This superficial location makes it easy to block the ganglion transnasally by topical anesthesia or by injection through many approaches including transnasal, intraoral, infrazygomatic and suprazygomatic approaches.

研究类型

介入性

注册 (估计的)

70

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

  • 姓名：Nada A Fathy, MSc
  • 电话号码：00201094049394
  • 邮箱：nashrsf@gmail.com

学习地点

  • 埃及
      • Cairo、埃及、12613
        • 招聘中
        • Cairo University
        • 接触：
        • 副研究员：
          • Khaled Alshafei, MD
        • 副研究员：
          • Safinaz H Osman, MD
        • 副研究员：
          • Mohamed Farid, MD
        • 副研究员：
          • Maged Gamal, MD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 孩子
  • 成人

接受健康志愿者

不

描述

Inclusion Criteria:

  • Age between 21 and 60 years.
  • American Society of Anesthesiologists (ASA) Physical Status I or II.
  • Undergoing elective endoscopic trans-nasal resection of pituitary adenoma.

Exclusion Criteria:

  • Patient's refusal
  • ASA Physical Status III or IV patients
  • Patients receiving drugs influencing blood coagulation
  • Allergy to any of the drugs utilized in this study
  • History of chronic pain therapy
  • Inadvertent intra-operative vascular injury

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：双倍的

武器和干预

参与者组/臂
干预/治疗
实验性的：Group A
Patients will receive sphenopalatine ganglion block (SPGB) using 4 mL of 0.25% bupivacaine combined with 1 mL of dexamethasone .
药品：Sphenopalatine ganglion block using bupivacaine + dexamethasone
Patients will receive sphenopalatine ganglion block (SPGB) using 4 mL of 0.25% bupivacaine combined with 1 mL of dexamethasone.
有源比较器：Group B
Patients will receive general anesthesia alone.
其他：General anesthesia
Patients will receive general anesthesia alone.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Quality of surgical field visibility
大体时间：Intraoperatively

Quality of surgical field visibility will be measured at the beginning of surgery and at 30 mins interval through a pre-defined average category scale (ACS) (from 0 to 5). The ideal category scale values for surgical conditions were pre-determined to be ≤3.

0=No bleeding

  1. Slight bleeding - no suctioning of blood required
  2. Slight bleeding - occasional suctioning required. Surgical field not threatened
  3. Slight bleeding - frequent suctioning required. Bleeding threatens surgical field a few seconds after suction is removed
  4. Moderate bleeding - frequent suctioning required. Bleeding threatens surgical field directly after suction is removed
  5. Severe bleeding - constant suctioning required. Bleeding appears faster than can be removed by suction. Surgical field severely threatened and surgery not possible
Intraoperatively

次要结果测量

结果测量
措施说明
大体时间
Intraoperative fentanyl consumption
大体时间：Intraoperatively
The hemodynamic objective of the anesthetic plan is to maintain mean arterial pressure values between 60 mmHg and 65 mmHg to produce an optimal surgical field, this will be done by injection of increments of fentanyl (0.5 μg/kg) up to total dose of 3 μg/kg
Intraoperatively
Total dose of propranolol
大体时间：Intraoperatively
In case of reflex persistent increase in heart rate (HR) >100 beats/min, i.v. 0.2 mg increments of propranolol will be given to maintain HR 60-70 beats/min.
Intraoperatively
Total dose of nitroglycerine
大体时间：Intraoperatively
In case of reduction of mean arterial pressure (MAP), nitroglycerine infusion will be done through adjustment from 0.5 to 10 μg/kg/ min according to patient response.
Intraoperatively
Amount of intraoperative blood loss
大体时间：Intraoperatively
Amount of intraoperative blood loss (by measuring the volume of blood in suction reservoir minus the normal saline used to wash the surgical field)
Intraoperatively
Degree of pain
大体时间：24 hours postoperatively
Each patient will be instructed about postoperative pain assessment with visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be measured immediately after the operation, then at 2, 12, and 24hrs.
24 hours postoperatively
Time of 1st analgesia requirement
大体时间：24 hours postoperatively
Postoperative analgesia is performed with administration of paracetamol/acetaminophen (1 g three times a day) and visual analog scale (VAS) ≥4 will be managed by IV dose of 25mg pethidine.
24 hours postoperatively
Total meperidine consumption
大体时间：24 hours postoperatively
Total postoperative meperidine consumption will be recorded.
24 hours postoperatively
Incidence of postoperative side effects
大体时间：24 hours postoperatively
Incidence of postoperative side effects such as postoperative nausea and vomiting (PONV), headache, visual disturbances, agitation or somnolence will be recorded.
24 hours postoperatively

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Cairo University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2025年6月1日

初级完成 (估计的)

2026年6月1日

研究完成 (估计的)

2026年6月1日

研究注册日期

首次提交

2026年4月21日

首先提交符合 QC 标准的

2026年4月29日

首次发布 (实际的)

2026年5月6日

研究记录更新

最后更新发布 (实际的)

2026年5月6日

上次提交的符合 QC 标准的更新

2026年4月29日

最后验证

2026年4月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • MD-113-2025

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

IPD 计划说明

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

IPD 共享时间框架

After the end of study for one year.

IPD 共享访问标准

The data will be available upon a reasonable request from the corresponding author

IPD 共享支持信息类型

  • 研究方案

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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