Comparative Evaluation of efficacy of Ultrasound guided versus Landmark technique of Sphenopalatine ganglion nerve block in patients undergoing Functional Endoscopic Sinus Surgery: A Randomized, Open -label, Superiority Trial

This prospective, randomized, single-blinded superiority trial will compare the efficacy of ultrasound-guided versus traditional trans-nasal sphenopalatine ganglion block (SPGB) in adult patients undergoing Functional Endoscopic Sinus Surgery (FESS) at AIIMS Nagpur. Postoperative pain and haemodynamic instability remain major concerns in FESS, and SPG block is an emerging technique to improve perioperative analgesia. While the trans-nasal method is simple but variable, ultrasound guidance may offer more accurate drug deposition with improved safety and efficacy.

A total of 60 patients, aged 18–50 years with ASA I–II status, will be randomly allocated into two equal groups: Group N (trans-nasal SPGB) and Group U (ultrasound-guided SPGB). All patients will undergo standardized general anaesthesia. Group N will receive a cotton-swab–based bupivacaine application, while Group U will receive a targeted injection under ultrasound visualization.

The primary outcome is intraoperative haemodynamic stability measured through heart rate and mean arterial pressure. Secondary outcomes include total intraoperative opioid requirement, need for dexmedetomidine for controlled hypotension, surgical field quality, block performance time, postoperative VAS scores, and complications within 24 hours.

Data will be analysed using appropriate parametric or non-parametric tests, with significance set at p<0.05. The study aims to generate evidence to guide optimal SPGB technique for improved perioperative outcomes in FESS.