title: Infiltration of the sphenopalatine ganglion decreases blood pressure in newly diagnosed and never treated patients with essential hypertension.
abstract: BACKGROUND
  Sphenopalatine ganglion (SPG), an extracranial structure, is connected with the central nervous system (CNS) through sympathetic and parasympathetic nerves. We hypothesized that SPG block through sympathetic nerves anesthesia might decrease blood pressure (BP) in recently diagnosed and never treated middle-aged patients with essential hypertension.
  
  
  METHODS
  We performed SBG block in 22 hypertensive patients (mean age 45±12years, 15 men). All patients have been subjected to 24hour ambulatory blood pressure monitoring a week prior the procedure as well as in a period of 21-30days after the SBG block in order to estimate differences in 24h average systolic (24h SBP) and diastolic blood pressure (24h DBP), daytime, nighttime, pre-awake and early morning SBP and DBP as well as BP load.
  
  
  RESULTS
  We found that 24h SBP (p=0.001) and 24h DBP (p<0.001), daytime SBP and DBP (p<0.001) as well as daytime SBP and DBP load (p=0.002 and p<0.001, respectively) were decreased in total population at 21-30days after SPG block. In 11/22 responders (24h SBP decrease ≥5mmHg), SBP and DBP were reduced during overall 24h and daytime (p<0.001) and nighttime periods (p=0.01 and p=0.06, respectively) while pre-awake SBP (p=0.09) along with daytime SBP and DBP load (p=0.07 and p=0.06, respectively) were also almost decreased.
  
  
  CONCLUSIONS
  SBG block might be a promising, non-invasive, safe, painless and easy to perform therapeutic option of BP decrease. As with renal denervation, SBG should be effective in those hypertensive patients with an activated SNS, so a period of patient selection should precede the application of this procedure.
authors.affiliation: 2nd Cardiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece. Electronic address: seliani@hotmail.com.
authors.forename: Helen
authors.initials: H
authors.lastname: Triantafyllidi
authors.affiliation: Pain Unit, 2nd Anaesthesiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Chrysa
authors.initials: C
authors.lastname: Arvaniti
authors.affiliation: 2nd Cardiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Palaiodimos
authors.affiliation: 2nd Cardiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Vlachos
authors.affiliation: 2nd Cardiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Schoinas
authors.affiliation: Pain Unit, 2nd Anaesthesiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Batistaki
authors.affiliation: Pain Unit, 2nd Anaesthesiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.affiliation: 2nd Cardiology Department, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D059387:Sphenopalatine Ganglion Block / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: 24h blood pressure measurement (24h ABPM); Arterial hypertension; Neural block; Sphenopalatine ganglion