ROLE OF SPHENOPALATINE GANGLION BLOCK IN REDUCING PERIOPERATIVE OPIOID CONSUMPTION IN TONGUE CANCER SURGERY: A CLINICAL CASE SERIES
DOI:
https://doi.org/10.22159/ijcpr.2026v18i1.8024%20Keywords:
Cancer of head and neck, Enhanced recovery after surgery, Regional anaesthesia, Pterygopalatine ganglion block, UltrasonographyAbstract
Objective: To determine the time interval for first rescue analgesia that is intravenous diclofenac in the post-anaesthesia care unit and assess its impact on perioperative fentanyl consumption.
Methods: This case series evaluated sphenopalatine ganglion block (SPGB) as an adjunct to general anaesthesia in seven patients with carcinoma of the tongue who underwent elective surgery. The ultrasound-guided SPGB via suprazygomatic approach using 4 ml of 0.5% bupivacaine was performed after administering general anaesthesia to the patient.
Results: SPGB was successfully performed within 5–6 min and was associated with 200–260ug perioperative fentanyl and 2.0–3.1µg/kg/min nitro-glycerine use. Hemodynamic remained stable, blood loss was 140–180 ml, and the surgical field improved. Postoperatively, pain scores (VAS<3) were maintained for 22–24 h, with delayed need for rescue analgesia, effectively managed with intravenous diclofenac. No major complications were observed.
Conclusion: These findings suggest that SPGB is a simple, safe, and effective component of enhanced recovery after surgery (ERAS) in oral cancer surgery, reducing opioid consumption and improving surgical and postoperative outcomes.
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