A Randomized Double-Blind Clinical Trial to Compare the Effectiveness of Intranasal and Transoral Approaches of Sphenopalatine Ganglion Block for Postoperative Analgesia Following Functional Endoscopic Sinus Surgery

All the patients will recieve standard General anesthesia

Participants will be randomly assigned to Group I intranasal or Group T transoral using a computer-generated block randomization

Allocation will be concealed via sequentially numbered, opaque, sealed envelopes prepared by an independent researcher

Transoral Approach - A 24G bent needle is inserted near the second molar, 1.5 to 2 ml of local anesthetic is injected and repeated on the opposite side

Intranasal Approach - Cotton pledgets soaked in 2 ml of local anesthetic are inserted along the superior border of middle terminate to reach posterior nasopharyngeal wall where SPG lies. Left for 5 to 10 min for anesthetic absorption and then repeated on the opposite side

Following a 10 min wait post block, conventional septoplasty will be performed

After extubation, patient will be assessed by a blinded observer for post operative pain using a VAS at intervals 0 min, 30 min, 1 hr, 2 hr, 4 hr and 6 hr.

If VAS score is greater than 4, rescue analgesia with IV diclofenac 75 mg will be given

Time to 1st rescue analgesia and total post operative analgesia consumption will be recorded.

Post operative complications like nausea, vomiting, headache, visual disturbances will be monitored for 24 hr post procedure