Pain Management Procedures
Sphenopalatine Ganglion Block
Sphenopalatine Ganglion Block
What is it?
The sphenopalatine ganglion, or SPG, is a bundle of nerves deep behind the nose that participates in headache and facial-pain pathways. An SPG block delivers numbing medicine to this area, most often through the nasal passage. It does not involve an injection through the cheek in the common transnasal approach.
When may it be recommended?
The block may be considered for selected cases of migraine, cluster headache, trigeminal neuralgia, or other difficult craniofacial pain. Evidence and response vary by diagnosis and technique. It is generally an option after a clinician has confirmed that the symptom pattern fits a condition in which the SPG may play a role.
What happens?
You usually recline with your head supported. After the nasal passage is examined, local anesthetic is applied near the back of the nose with a small catheter or applicator. Some techniques use image-guided needle placement from another route. The team will explain which method is planned. The procedure is generally brief, and monitoring may continue for a short time afterward.
What should I expect?
Temporary numbness in the nose, throat, roof of the mouth, or upper teeth can occur. You may notice a bitter taste, watery eyes, or brief nasal drainage. Relief, when it occurs, may be rapid but can also be temporary. A short response may provide useful diagnostic information.
Important risks and limitations
Nosebleed, lightheadedness, gagging, temporary throat numbness, infection, or medication reaction are possible. Avoid eating or drinking until throat sensation is normal if the care team instructs you to do so. This block is not appropriate for every headache, and it does not replace evaluation of new or dangerous headache symptoms.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.