الفهرس 
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Abstract
Chronic rhinosinusitis (CRS) and nasal polyps may be effectively treated with functional endoscopic sinus surgery (FESS), a less invasive form of sinus surgery. Despite the fact that most FESS studies have focused on how the procedure affects patients’ quality of life, there has been very little investigation into its underlying mechanisms, indications, or surgical field. Few investigations focused on the relationship between surgical environment and intra- and postoperative pain (POP). Patient satisfaction decreases, healthcare expenses rise, and the risk of life-threatening respiratory and cardiovascular problems rises when pain is not well managed. Despite widespread agreement on the need for more accessible postoperative pain treatment, no standards exist for how FESS patients should have their POP handled.
The requirement of systemic analgesia after surgery may be minimised by using regional anaesthetic treatments to lessen the intensity of painful sensations. It is also possible to provide adequate intraoperative surgical condition management without compromising patient recovery time.
Almost all of the sensory nerve endings in the mucosa of the nasal cavity and sinuses originate in the sphenopalatine ganglion (SPG).
The purpose of this study was to evaluate the relative advantages of direct endoscopic SPGB with local anaesthetic versus trans-nasal greater palatine foramen injection prior to endoscopic sinus surgery (FESS) in terms of intraoperative field conditions, postoperative pain, analgesic requirements, and the occurrence of postoperative complications.
The research was done between and at Minya University Hospital after receiving approval from the hospital’s institutional review board (November 2021 to April 2022). Sixty adult patients participated in this prospective randomised double-blind controlled research.
The most important findings were:
-There were no statistically significant differences between the groups, with mean blood loss (in ml) of 70.3, 72.45, and 75.1.
There were statistically significant differences between the block groups (M&B) and the non-block group in the average category scale (ACS)A VAS score immediately after anaesthesia and on the first post-operative day (group C). There were no significant changes between the groups 15, 30, 45, 60, 75, 90, or 120 minutes after the induction.
Regarding rescue analgesia, there was a statistically significant difference between the three groups.
Time to first analgesic dosage varied considerably across the study’s three groups, and this variation was shown to be statistically significant.
Comparing Mean Arterial Blood Pressure and heart rate across the three groups, we found no statistically significant differences.
group I patients reported 35% satisfaction, group II patients reported 75% satisfaction, and group III patients reported 75% satisfaction; however, there were significant differences between the groups due to the use of SPGB to alleviate postoperative pain, discomfort, improve patient functional outcomes after FESS, and reduce the need for opiates.