Exparel has a proven efficacy in providing pain relief for up to 72 hours with a single-dose administration at surgical sites. The study aims to evaluate the effectiveness of endoscopically-guided injection of Exparel (Bupivacaine) for the treatment of craniofacial pain. This study would be conducted in a prospective, randomized, double-blinded, placebo- controlled, and cross-over fashion. We aim to investigate whether the administration of Exparel (Bupivacaine) to the lateral nasal wall may positively impact craniofacial pain and functional outcomes, in patients who experience relief with the topical application of Lidocaine (routinely given prior to almost all ENT endoscopy).

Inclusion Criteria:

• Patients with a chief complaint of craniofacial pain (migraine, cluster headache, trigeminal autonomic cephalgia, sphenopalatine ganglioneuraligia, paroxysmal hemicrania) who has Stanford Pain & ENT clinic visit

Exclusion Criteria:

• age <18 or >80
• pregnant women
• economically disadvantaged (not able to afford clinic visits/treatments)
• decisionally impaired (unable to obtain informed consent)
• has allergy to bupivacaine
• unable or unwilling to participate plans to participate in another clinical study at any time during this study

IPD will be kept confidential and private and won't be used for any other studies or shared with other researchers.