Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study

Helen Triantafyllidi, Chrysa Arvaniti, Antonios Schoinas, Dimitris Benas, Stefanos Vlachos, Leonidas Palaiodimos, George Pavlidis, Ignatios Ikonomidis, Chrysanthi Batistaki, Costas Voumvourakis, John Lekakis

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48 ± 12 years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51 ± 12 years, 8 men). All patients have been subjected to 24 h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24 h SBP decrease ≥ 5 mm Hg. Results We found that 24 h and daytime DBP (p = 0.02) as well as daytime DBP load (p = 0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24 h and daytime (p < 0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group. Conclusions SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.

Original languageEnglish (US)
Pages (from-to)233-239
Number of pages7
JournalInternational Journal of Cardiology
Volume250
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Fingerprint

Sphenopalatine Ganglion Block
Blood Pressure
Adrenergic Fibers
Ambulatory Blood Pressure Monitoring
Lidocaine
Ganglia
Antihypertensive Agents
Anesthetics
Essential Hypertension
Central Nervous System
Control Groups
Injections
Water

Keywords

  • 24 h blood pressure measurement (24 h ABPM)
  • Arterial hypertension
  • Neural block
  • Sphenopalatine ganglion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study. / Triantafyllidi, Helen; Arvaniti, Chrysa; Schoinas, Antonios; Benas, Dimitris; Vlachos, Stefanos; Palaiodimos, Leonidas; Pavlidis, George; Ikonomidis, Ignatios; Batistaki, Chrysanthi; Voumvourakis, Costas; Lekakis, John.

In: International Journal of Cardiology, Vol. 250, 01.01.2018, p. 233-239.

Research output: Contribution to journalArticle

Triantafyllidi, H, Arvaniti, C, Schoinas, A, Benas, D, Vlachos, S, Palaiodimos, L, Pavlidis, G, Ikonomidis, I, Batistaki, C, Voumvourakis, C & Lekakis, J 2018, 'Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study', International Journal of Cardiology, vol. 250, pp. 233-239. https://doi.org/10.1016/j.ijcard.2017.10.042
Triantafyllidi, Helen ; Arvaniti, Chrysa ; Schoinas, Antonios ; Benas, Dimitris ; Vlachos, Stefanos ; Palaiodimos, Leonidas ; Pavlidis, George ; Ikonomidis, Ignatios ; Batistaki, Chrysanthi ; Voumvourakis, Costas ; Lekakis, John. / Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study. In: International Journal of Cardiology. 2018 ; Vol. 250. pp. 233-239.
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abstract = "Background Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2{\%} in 33 hypertensive patients (mean age 48 ± 12 years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51 ± 12 years, 8 men). All patients have been subjected to 24 h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24 h SBP decrease ≥ 5 mm Hg. Results We found that 24 h and daytime DBP (p = 0.02) as well as daytime DBP load (p = 0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36{\%}) regarding: a. SBP and DBP during overall 24 h and daytime (p < 0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group. Conclusions SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.",
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T1 - Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study

AU - Triantafyllidi, Helen

AU - Arvaniti, Chrysa

AU - Schoinas, Antonios

AU - Benas, Dimitris

AU - Vlachos, Stefanos

AU - Palaiodimos, Leonidas

AU - Pavlidis, George

AU - Ikonomidis, Ignatios

AU - Batistaki, Chrysanthi

AU - Voumvourakis, Costas

AU - Lekakis, John

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48 ± 12 years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51 ± 12 years, 8 men). All patients have been subjected to 24 h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24 h SBP decrease ≥ 5 mm Hg. Results We found that 24 h and daytime DBP (p = 0.02) as well as daytime DBP load (p = 0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24 h and daytime (p < 0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group. Conclusions SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.

AB - Background Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48 ± 12 years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51 ± 12 years, 8 men). All patients have been subjected to 24 h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24 h SBP decrease ≥ 5 mm Hg. Results We found that 24 h and daytime DBP (p = 0.02) as well as daytime DBP load (p = 0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24 h and daytime (p < 0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group. Conclusions SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.

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KW - Neural block

KW - Sphenopalatine ganglion

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