LAUSR

OBJECTIVES Large-scale procedural safety data on pterygopalatine fossa nerve blocks (PPFB) using a suprazygomatic, ultrasound-guided approach are lacking, leading to hesitancy surrounding this technique. The aim of this study was to characterize the safety of PPFB. METHODS This retrospective chart review comprised adults who received an ultrasound-guided PPFB from 01/01/2016-08/30/2020 at the University of Florida. Indications included surgical procedures and non-surgical pain. Clinical data describing PPFB were extracted from medical records. Descriptive statistics were calculated for all variables, and quantitative variables were analyzed using the paired t-test to detect differences between pre- and post-procedure. RESULTS A total of 833 distinct PPFBs were performed on 411 subjects (59% female, mean age 48.5 years). Minor oozing from the injection site was the only reported side effect in a single subject. While systolic blood pressure, heart rate and oxygen saturation were significantly different pre- and post-procedure (132.3 vs 136.4 mmHg, p < 0.0001; 78.2 vs 80.8, p = 0.0003; and 97.8% vs 96.3%, p < 0.0001 respectively), mean arterial pressure and diastolic blood pressure were not significantly different (96.2 vs 97.1, p = 0.1545; and 78.2 vs 77.4 mmHg, p = 0.1314 respectively). Similar results were found within subgroups, including sex, race, and indication for PPFB. DISCUSSION We have not identified clinically significant adverse effects from PPFB using an ultrasound-guided suprazygomatic approach in a large cohort in the hospital setting. PPFBs are a safe and well-tolerated pain management strategy; however, prospective multicenter studies are needed.