Trans-nasal Sphenopalatine Ganglion Block for Prevention of Emergence Agitation Following Functional Endoscopic Sinus Surgery

Effect of Bilateral Trans-nasal Sphenopalatine Ganglion Block on Emergence Agitation Following Functional Endoscopic Sinus Surgery: A Double-Blind Randomized Controlled Trial

This randomized double-blind controlled trial aims to evaluate whether bilateral trans-nasal sphenopalatine ganglion block (SPGB) using bupivacaine reduces the incidence of emergence agitation following Functional Endoscopic Sinus Surgery (FESS) compared with placebo. Secondary objectives include evaluation of postoperative pain, postoperative opioid consumption, hemodynamic parameters, postoperative nausea and vomiting, and adverse events.

Inclusion Criteria

• Age 18-65 years.
• ASA physical status I-II.
• Scheduled for elective FESS under general anesthesia.
• Ability to provide informed consent. Exclusion Criteria
• ASA physical status III or higher.
• Known allergy or contraindication to local anesthetics.
• Coagulopathy or anticoagulant therapy.
• Psychiatric illness or cognitive impairment affecting agitation assessment.
• Chronic opioid use or substance abuse.
• Pregnancy or lactation.
• Revision nasal surgery or anatomical abnormalities preventing SPGB.
• Intraoperative complications requiring deviation from the study protocol.