Evidence map›Paper›PMID 41299271›Full record

SynthesisBMC anesthesiology2025

Comparative efficacy of sphenopalatine ganglion block versus scalp block for hemodynamic stability during craniotomy: a systematic review and meta-analysis.

Sudadi Sudadi, Fiandila Elvana Deviatika, Girija Prasad Rath, Muhammad Yogi Pradani, Febrian Naufaldi, Bhirowo Yudo Pratomo

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sudadi SudadiDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sardjito General Hospital - Jl, Kesehatan No. 1, Sendowo, Sekip Utara, Depok District, Sleman Regency, Yogyakarta, Yogyakarta Special Region, 55281, Indonesia. dsudadi@ugm.ac.id.
Fiandila Elvana DeviatikaFaculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Girija Prasad RathDepartment of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Muhammad Yogi PradaniDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sardjito General Hospital - Jl, Kesehatan No. 1, Sendowo, Sekip Utara, Depok District, Sleman Regency, Yogyakarta, Yogyakarta Special Region, 55281, Indonesia.
Febrian NaufaldiDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sardjito General Hospital - Jl, Kesehatan No. 1, Sendowo, Sekip Utara, Depok District, Sleman Regency, Yogyakarta, Yogyakarta Special Region, 55281, Indonesia.
Bhirowo Yudo PratomoDepartment of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sardjito General Hospital - Jl, Kesehatan No. 1, Sendowo, Sekip Utara, Depok District, Sleman Regency, Yogyakarta, Yogyakarta Special Region, 55281, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaintaining hemodynamic stability during craniotomy is essential to prevent elevated intracranial pressure and related complications. Regional blocks, including sphenopalatine ganglion (SPG) block and scalp block, may stabilize hemodynamics, but comparative evidence is limited. This study systematically evaluated the efficacy and safety of SPG block versus scalp block in adults undergoing craniotomy.

methodsThis systematic review and meta-analysis adhered to the PRISMA guidelines. We searched PubMed, CENTRAL, Scopus, and EBSCO (2010–2025). Eligible studies were randomized controlled trials (RCTs) comparing SPG block with scalp block in adult craniotomy patients. Primary outcomes were intraoperative MAP and HR. Secondary outcomes included intracranial pressure (ICP), postoperative pain, opioid use, and complications. Data were synthesized using random-effects meta-analysis.

resultsFive RCTs (n = 285) were included. No significant differences in MAP or HR were observed in the SPG block group compared with the control group at all measured time points, including post–pin insertion, post–skin incision, and post–dural incision. (peak MAP = -0.01 [-0.12–0.09]; cumulative MAP = 0.00 [-0.14–0.13]; peak HR = -0.05 [-0.16–0.06]; cumulative HR = -0.09 [-0.19–0.02]). Secondary outcomes suggested SPG block may lower ICP, improve brain relaxation, and reduce postoperative pain and opioid requirement with minimal complications.

conclusionBoth SPG block and scalp block maintained intraoperative hemodynamic stability. However, SPG block demonstrated additional advantages, including improved postoperative analgesia, lower intracranial pressure, and enhanced brain relaxation, while remaining a simple and noninvasive technique with minimal adverse effects. Evidence is limited by small sample sizes, highlighting the need for larger, standardized trials to confirm these findings.

trial registrationPROSPERO ID: CRD420251131959.

Indexed as

CraniotomyHemodynamicsNerve BlockScalpSphenopalatine Ganglion BlockHumansPostoperative PainRandomized Controlled Trials as TopicAnesthesia, localBlood pressureCraniotomyHeart rateHemodynamicsScalpSphenopalatine ganglion block

Identifiers

PMID41299271
PMCPMC12763957

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.