Intranasal self-administration of local anesthetic (ropivacaine) for sphenopalatine ganglion block, for treatment of second trigeminal branch neuralgia secondary to maxillary sinus curettage: A case report

Rev Esp Anestesiol Reanim (Engl Ed). 2019 Oct;66(8):447-450. doi: 10.1016/j.redar.2019.02.007. Epub 2019 Aug 5.
[Article in English, Spanish]


Trigeminal neuralgia (TN) is a severe and often underestimated facial pain that affects quality of life. Pharmacological treatment is insufficient for pain control in 30% of cases and, although intervention techniques may be effective, there is a possibility of relapse and associated complications. The second division of the trigeminal nerve (V2) runs through the sphenopalatine ganglion (SPG), which is anatomically accessible to blocking due to its superficial location in the nasal cavity. We report a clinical case of a patient with uncontrolled V2 TN that was put on ambulatory self-administered SPG block with nasal swabs soaked in 0.75% ropivacaine. In the follow-up visits, we confirmed that this adjuvant treatment provided a significant pain relief over 24hours with a decrease in the number of exacerbations.

Keywords: Adjuvant treatment; Bloqueo del ganglio esfenopalatino; Hisopo nasal; Intranasal ropivacaine; Nasal swab; Neuralgia del trigémino; Ropivacaína intranasal; Sphenopalatine ganglion block; Tratamiento adyuvante; Trigeminal neuralgia.

MeSH terms

  • Administration, Intranasal
  • Aged
  • Analgesics / therapeutic use
  • Anesthetics, Local / administration & dosage*
  • Antidepressive Agents / therapeutic use
  • Combined Modality Therapy
  • Curettage / adverse effects*
  • Facial Pain / drug therapy
  • Facial Pain / etiology
  • Facial Pain / therapy*
  • Humans
  • Instillation, Drug
  • Intraoperative Complications / drug therapy
  • Intraoperative Complications / etiology
  • Intraoperative Complications / physiopathology
  • Intraoperative Complications / therapy*
  • Male
  • Mandibular Nerve Injuries / drug therapy
  • Mandibular Nerve Injuries / etiology
  • Mandibular Nerve Injuries / physiopathology
  • Mandibular Nerve Injuries / therapy*
  • Maxillary Sinus / surgery*
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Pain, Postoperative / therapy*
  • Ropivacaine / administration & dosage*
  • Self Administration
  • Sphenopalatine Ganglion Block / methods*
  • Trigeminal Neuralgia / drug therapy
  • Trigeminal Neuralgia / etiology
  • Trigeminal Neuralgia / therapy*


  • Analgesics
  • Anesthetics, Local
  • Antidepressive Agents
  • Ropivacaine