Role of pre-incisional external bilateral ultrasound guide glossopharyngeal nerve block with diluted bupivacaine mixture in pain management in oropharyngeal surgery: A randomized control trial

Abstract

The glossopharyngeal nerve block (GNB) was evaluated for pain control together with the magnitude of obtunded gag reflex as a useful clinical sign of GNB.

Methods: 400 patients scheduled for oropharyngeal surgery were randomly allocated into 2 groups (200 patients in each group), Group1 patients received bilateral GNB with 0.125% bupivacaine, 0.5 xylocaine, and 4 mg dexamethasone, while Group 2 patients were enrolled as a control group. Throat pain was evaluated using the visual analog scale at 0.5, 8, and 24 h after surgery, and the degree of gag reflex response was evaluated at the same time points.

Results: Postoperative pain scores at rest and during swallowing were significantly lower in Group 1 versus Group 2. The analgesic efficacy of GNB was intensely interrelated with the magnitude of the obtunded gag reflex (P 0.01).

Conclusions: GNB is beneficial for pain control in oropharyngeal surgery. An obtunded gag reflex could be a useful clinical sign for a successful GNB analgesic outcome.

Keywords: Glossopharyngeal nerve block; Post-operative pain; Upper airway surgery.