Comparison of the Efficacy of Ultrasound-Guided Suprazygomatic Maxillary Nerve Block versus Transnasal Sphenopalatine Ganglion Block in Functional Endoscopic Sinus Surgeries - A Randomized Clinical Trial

The leading cause of postoperative pain and discomfort after FESS is the resection of the facial bones around the nasal cavity. The maxillary nerve is the principal nerve supplying the nasal septum, the lateral nasal wall, and the maxillary sinus. The blockade of sensory nerve fibres of the maxillary nerve can relieve postoperative pain in FESS. Sphenopalatine ganglion block (SPGB) in pterygopalatine fossa is known to be a comfortable, efficient and safe method for managing craniofacial pains. The ganglion is made of both sensory and autonomic nerves, with sensory neurons innervating the nasal cavity, palate, and some regions in nasopharynx and oropharynx. SPG block can be performed through transnasal, transoral or transcutaneous approaches. Transnasal SPG block has been frequently used to treat facial pain. The USG- guided suprazygomatic maxillary nerve block (SZMNB) is the easiest approach to the pterygopalatine fossa.This approach avoids penetration of the base of the skull and the orbit. Bony landmarks used are more superficial, more easily palpated, simplifying block performance and improving safety. In this study, We aim to assess the efficacy of ultrasound guided supra-zygomatic maxillary nerve block versus Transnasal Sphenopalatine Ganglion Block for patients undergoing FESS surgeries.