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Purpose <p>We aim to explore existing literature for use of intranasal local anaesthetic (LA) spray for sphenopalatine ganglion (SPG) block in trigeminal neuralgia (TN) and its limitations, as well as establish the need for further high evidence studies.</p> Method <p>In this narrative review, adult patients suffering from paroxysmal pain due to TN regardless of etiology were included. The main predictor was intranasal lignocaine spray for therapeutic relief from TN induced pain and the comparative therapy was placebo saline spray or medical intervention. The outcome variables were effectiveness of the intranasal LA spray SPG block in moderating pain with minimum trauma to the patient and providing quick relief along with improving quality of life.</p> Results <p>Out of 7 relevant publications identified, one was randomized controlled trial (RCT) (Japan), another was case series (India) and rest were reviews or meta-analysis from United States of America, Greece, Italy, and Republic of Korea. The RCT included 25 patients (20 female, 5 male) with age ranging from 35 to 85 years (Mean 64). The pre-treatment mean visual analog scale (VAS) score reduced from 8.0 (2.0) cm to 1.5 (1.9) cm at 15&#xa0;min post spray (<i>P</i> &lt; 0.01; paired Students’t-test). The case series included 7 patients (3 female, 4 male) with age ranging from 42 to 81 years (Mean ± SD (CI) 60 ± 12.13 (4.58)). The pre-treatment Median (IQR) VAS was 8(3) whereas post-treatment VAS were 2(4), 2(4) and 1(4) at 30&#xa0;min, 60&#xa0;min and 24&#xa0;h respectively.</p> Conclusions <p>There is emerging evidence for use of intranasal spray for SPG block as a safe and efficient adjuvant technique to provide rapid relief in TN, especially acute exacerbations. However, the current evidence base is insufficient and requires further large scale trials.</p>

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Intranasal Local Anaesthetic Spray for Sphenopalatine Ganglion Block in Trigeminal Neuralgia: A Narrative Review

  • 期刊论文

  • 发表日期：

    2025年12月9日

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  • Preksha Dubey

摘要

Purpose

We aim to explore existing literature for use of intranasal local anaesthetic (LA) spray for sphenopalatine ganglion (SPG) block in trigeminal neuralgia (TN) and its limitations, as well as establish the need for further high evidence studies.

Method

In this narrative review, adult patients suffering from paroxysmal pain due to TN regardless of etiology were included. The main predictor was intranasal lignocaine spray for therapeutic relief from TN induced pain and the comparative therapy was placebo saline spray or medical intervention. The outcome variables were effectiveness of the intranasal LA spray SPG block in moderating pain with minimum trauma to the patient and providing quick relief along with improving quality of life.

Results

Out of 7 relevant publications identified, one was randomized controlled trial (RCT) (Japan), another was case series (India) and rest were reviews or meta-analysis from United States of America, Greece, Italy, and Republic of Korea. The RCT included 25 patients (20 female, 5 male) with age ranging from 35 to 85 years (Mean 64). The pre-treatment mean visual analog scale (VAS) score reduced from 8.0 (2.0) cm to 1.5 (1.9) cm at 15 min post spray (P < 0.01; paired Students’t-test). The case series included 7 patients (3 female, 4 male) with age ranging from 42 to 81 years (Mean ± SD (CI) 60 ± 12.13 (4.58)). The pre-treatment Median (IQR) VAS was 8(3) whereas post-treatment VAS were 2(4), 2(4) and 1(4) at 30 min, 60 min and 24 h respectively.

Conclusions

There is emerging evidence for use of intranasal spray for SPG block as a safe and efficient adjuvant technique to provide rapid relief in TN, especially acute exacerbations. However, the current evidence base is insufficient and requires further large scale trials.