Sphenopalatine Ganglion Block

A few small structures (ganglia and associated nerves) located near the middle of the head are primarily responsible for dilation or constriction of blood vessels. Irritation within these structures is one of the primary causes of recurrent headaches (migraine, cluster, etc.). A sphenopalatine ganglion (SPG) block involves the safe delivery of anesthetic to the back of the nasal cavity via the nostril. Delivery of anesthetic to this location helps evaluate the source of head or facial pain, and often eliminates or significantly decreases pain.

An SPG block is a low-risk, minimally invasive procedure that can be effective when other treatments have failed. It can be repeated in 1-2-week intervals, if necessary. Please note that an SPG block cannot be performed if you have an allergy to local anesthetic or an active respiratory infection (nasal congestion).

HOW DO I PREPARE FOR MY PROCEDURE?

• Take all prescribed medications (including anticoagulation medication) as directed before, during, and after the procedure.
• You may experience discomfort or dizziness, so please have someone accompany you on the day of your test. If this is your first SPG, you are required to have someone else drive you home.
• You will need to purchase Drixoral (decongestant spray) and bring it with you to your procedure. It must be the no-drip, original, unscented version. It is available over the counter. We will explain how to use it when you arrive for your appointment. Our booking coordinators will discuss this with you.
• If you are currently taking antibiotics, you will need to wait two days after your last dose to be able to have your injection done.
• Please drink water throughout the day of your appointment and make sure you are well hydrated prior to the procedure. Bring a water bottle with you to your appointment.
• Please arrive 15 minutes before your appointment to allow enough time to fill out a consent form.
• Bring photo identification and your provincial health card.
• Wear comfortable clothes.
• Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

• A team member will go over the consent form, explain procedure details, and answer any questions.
• We will then escort you to our treatment suite where you will meet the radiologist or anesthesiologist who will perform your exam.
• After the location is confirmed with X-ray guidance, the long-lasting freezing will be injected using a thin, flexible catheter.
• You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

• First 24 hours: 
  • No exercise or strenuous activity, including sexual activity for 24 hours post procedure.
  • Drink large amounts of fluids.
  • Keep a headache or pain diary after your procedure.
  • After your injection, you may have a bitter taste in your mouth due to the local anesthetic. You may also experience temporary dizziness or light-headedness; low blood pressure; numbness of the nose, throat and lips; a mildly bloody nose, tearing or facial flushing; and, rarely, a temporary increase in pain, nasal congestion, or nasal infection.
• Follow-up with your referring doctor as needed.

WHEN WILL I SEE RESULTS?

• Results can vary. Some patients experience some pain relief immediately.
• An SPG block can provide relief from days to months. If this procedure does not help relieve your symptoms, then you may need further evaluation by your referring doctor.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinics.