This is an interesting RCT which evaluates the prophylactic effect of bilateral endoscopic injection of local anaesthetic in the sphenopalatine ganglion (SPG) on postoperative nausea and vomiting (PONV). It has a robust design, and is sufficiently powered and blinded, with 100 patients in total enrolled in the study. The findings certainly suggest that whilst in total 36% of patients had PONV after FESS, in the treatment group 10 patients suffered PONV, and zero suffered severe PONV, whereas in the control group the values were 14 with PONV and four with severe PONV. This finding was statistically significant in the severe PONV group. Although in the standard group the p=0.3. It seems that a minor intervention performed at the end of the FESS can have a potential benefit for the recovery of the patient and reduce PONV so is certainly worth considering.

The role of Endoscopic Sphenopalatine Ganglion block on nausea and vomiting after sinus surgery.
Abubaker A, Al-Qudah MA.
AMERICAN JOURNAL OF RHINOLOGY & ALLERGY
2018;32(5):369-73.
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Joanna Stephens

Lister Hospital, Stevenage, UK.

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