Block of the Sphenopalatine Nerve Ganglion for Postoperative Analgesia
Block of the Sphenopalatine Nerve Ganglion for Postoperative Analgesia
Transsphenoidal surgery is considered safe and effective and is currently the procedure of
 choice for the removal of intrasellar lesions. Direct transnasal access to the sphenoid
 sinus, without the need for detachment of the nasal septum, provides less postoperative
 morbidity compared to traditional methods. Sphenopalatine ganglion block is known for its
 efficacy in otorhinolaryngological surgeries in which the sinuses are approached by
 transnasal endoscopy, as an important part of postoperative analgesia. However, in a
 neurosurgical environment, specifically in the treatment of tumors of the sella turcica, the
 use of the blockade of the referred ganglion to produce postoperative analgesia has been used
 in a scarce way in the literature. The primary objective of the study is to verify whether
 blocking the sphenopalatine nerve ganglion in the nasopharynx posterior wall provides better
 postoperative pain control in surgeries with nasal access for transsphenoidal approach,
 compared to the placebo group. As secondary objectives, the investigators will observe the
 consumption of opioids in the intraoperative period, in addition to the incidence of nausea,
 vomiting and postoperative headache also within 24 hours. Forty patients with physical status
 P1, P2 or P3 will be prospectively analyzed by the American Society of Anesthesiology (ASA)
 to undergo microsurgery for tumors with a sellar and / or suprasellar location, with
 transsphenoidal access, in patients with an age range between 18 and 64 years old, including
 men and women.
Transsphenoidal surgery is considered safe and effective and is currently the procedure of
 choice for the removal of intrasellar lesions. Direct transnasal access to the sphenoid
 sinus, without the need for detachment of the nasal septum, provides less postoperative
 morbidity compared to traditional methods. Sphenopalatine ganglion block is known for its
 efficacy in otorhinolaryngological surgeries in which the sinuses are approached by
 transnasal endoscopy, as an important part of postoperative analgesia. However, in a
 neurosurgical environment, specifically in the treatment of tumors of the sella turcica, the
 use of the blockade of the referred ganglion to produce postoperative analgesia has been used
 in a scarce way in the literature. The primary objective of the study is to verify whether
 blocking the sphenopalatine nerve ganglion in the nasopharynx posterior wall provides better
 postoperative pain control in surgeries with nasal access for transsphenoidal approach,
 compared to the placebo group. As secondary objectives, the investigators will observe the
 consumption of opioids in the intraoperative period, in addition to the incidence of nausea,
 vomiting and postoperative headache also within 24 hours. Forty patients with physical status
 P1, P2 or P3 will be prospectively analyzed by the American Society of Anesthesiology (ASA)
 to undergo microsurgery for tumors with a sellar and / or suprasellar location, with
 transsphenoidal access, in patients with an age range between 18 and 64 years old, including
 men and women. As for the surgical technique, both the use of the microscope and the
 endoscope will be considered. They will be randomly allocated to a placebo group (group P;
 0.9% saline, n = 20) and a test group (group R; ropivacaine 1%, n = 20).
Inclusion Criteria:

 1. Both genders;

 2. Age between 18 and 64 years;

 3. Physical status according to the American Society of Anesthesiologists (ASA) I, II and
 III

 4. Saddle or suprasellar tumors with transsphenoidal access;

 Exclusion Criteria:

 1. Participation in another study in the last month;

 2. Patients with a history of chronic pain;

 3. Previous surgeries with a transsphenoidal approach;

 4. Known hypersensitivity to ropivacaine;

 5. Patient's refusal;