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. Methods400 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. ResultsPostoperative 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). ConclusionsGNB is beneficial for pain control in oropharyngeal surgery. An obtunded gag reflex could be a useful clinical sign for a successful GNB analgesic outcome.