Glossopharyngeal Nerve Block for Post -Tonsillectomy Pain Relief

Tanta University

Status: Completed

Conditions: Analgesia

Treatments: Procedure: bilateral ultrasound guided GPN block

Study type: Interventional

Funder types: Other

Identifiers

NCT05435833

GPN block in tonsillectomy

Details and patient eligibility

About

The aim of the present study is to evaluate the efficacy and safety of Ultra-sound guided submandibular parapharyngeal glossopharyngeal nerve block as regards time for first need of analgesic as a primary outcome as well as pain score, total postoperative analgesic requirement, and incidence of complications as secondary outcomes

Full description

Tonsillectomy is one of the most frequent surgical procedures performed all over the world that has been identified as being severely painful especially in the adult population. Management of post tonsillectomy pain is of paramount importance in order to improve swallowing and enhance oral intake as well as to decrease the risk of dehydration, infection and secondary hemorrhage with a subsequent hastening of recovery.

A variety of analgesic regimens have been implemented to alleviate post-tonsillectomy pain, however; no consensus on the ideal analgesic regimen has been yet identified.

The Ultrasound (US)-guided glossopharyngeal nerve (GPN) block has been acknowledged as a feasible option for providing perioperative analgesia in tonsillectomy patients. It blocks sensory impulses from the posterior third of the tongue, palatine tonsil, and mucous membranes of the mouth and pharynx. Conventional techniques for blocking the GPN carry the risk of vascular puncture, inadvertent block of closely adjacent other cranial nerves, with increased probability of local anesthetic toxicity and even upper airway obstruction. Recently, a novel, safe, and reproducible US-guided GPN block technique has been introduced by Azman et al, which would block the GPN distally, in the tissue plane just next to the pharyngeal wall and relatively far from high risk nearby structures.

Enrollment: 50 patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients classified by the American society of Anesthesiologists ASA I and II patients
• Scheduled for tonsillectomy procedure

Exclusion criteria

• Patients' refusal
• History of diabetes mellitus,
• Cardiac, liver or renal impairment
• Obstructive sleep apnea syndrome
• Swallowing difficulty
• Intake of chronic pain medications or substance abuse
• Bleeding disorders
• Hypersensitivity to the used medication

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

Group I (glossopharyngeal nerve block group)

Experimental group

Description:

bilateral ultrasound guided GPN block will be performed after induction of anesthesia and pre incisional by an experienced anesthesiologist

Treatment:

Procedure: bilateral ultrasound guided GPN block

Group II(Control group)

No Intervention group

Description:

general anesthesia alone (no block)