Comparison of extraoral and intraoral routes of glossopharyngeal nerve block for pain relief in patient with carcinoma tongue

Singh, Neetu; Singh, Sarita; Mishra, Neel Kamal; Kumar, Vijay; Hemlata, .

doi:10.4103/jcrt.jcrt_309_18

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Therefore, GNB is reportedly effective in managing postoperative pain following oropharyngeal surgery [ 9 ]. Conventional GNB has the risk of intravascular injection in the intraoral and extraoral approaches, which can lead to local anesthesia-induced systemic toxicity [ 10 ]. Ultrasound-guided GNB facilitates real-time visualization of the block needle, vessels, and injected local anesthetic, reducing the risk of local anesthetic intravascular injection [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Post-tonsillectomy Analgesia: A Case Report

Sekiguchi,

Kojima,

Oue

et al. 2024

Cureus

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Tonsillectomy can lead to significant postoperative pain, which can impact the recovery process. Traditional analgesic approaches may entail risks due to medication use. Considering that the tonsils are innervated by the glossopharyngeal and maxillary nerves, implementing glossopharyngeal and maxillary nerve blocks can provide analgesia. Ultrasound guidance may improve its effectiveness and safety. A woman in her 30s with recurrent tonsillitis underwent tonsillectomy under general anesthesia. After induction, we performed an ultrasound-guided selective glossopharyngeal nerve block and an ultrasound-guided maxillary nerve block with ropivacaine. No analgesics were required during the six-day hospitalization period. There were no complications from the nerve blocks such as dysphagia or upper airway obstruction. The findings from this case indicated that the ultrasound-guided selective glossopharyngeal nerve block and ultrasound-guided maxillary nerve block provided effective analgesia after tonsillectomy without complications.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Post-tonsillectomy Analgesia: A Case Report

Sekiguchi,

Kojima,

Oue

et al. 2024

Cureus

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“…GPN block, that is conventionally performed in the peri-styloid region, has been shown to be effective for pain control in such patients. 1 2 3 The feasibility of distal GPN block was first assessed in a cadaveric study conducted by Ažman et al, in which methylene blue injected into the parapharyngeal space under ultrasound-guided injection was confirmed to infiltrate around the GPN on dissection. 5 We could perform distal GPN block successfully performed in all patients under ultrasound guidance and pain relief was obtained in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional techniques of GPN block include topical, intraoral and extraoral peri-styloid approaches, out of which the latter two work well for deeper tissue pathologies. 1 2 3 However, both the approaches have a risk of accidental intravascular injection and concurrent blockade of the vagus, spinal accessory, and hypoglossal nerves, all potentially leading to serious complications ranging from hoarseness of voice to life-threatening respiratory difficulty. 2 4…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided Glossopharyngeal Nerve Block—A New Paradigm in Pain Management

Yadav

Pulappadi

Singh

et al. 2022

Journal of Clinical Interventional Radiology ISVIR

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We report eight cases of oropharyngeal carcinoma in which ultrasound-guided percutaneous distal glossopharyngeal nerve (GPN) block was performed for pain relief. Mean age of the patients was 52 ± 11.5 [SD] years and median baseline pain score was 7 (IQR, 5–8). Under ultrasound guidance, mixture of ropivacaine and dexamethasone was injected into parapharyngeal space. Pain reduced after four weeks in all patients (median [IQR], 4 [2.5–5]). Median quality of life score improved as compared with baseline in physical health (63 [44–69] vs 50 [44–63]) and psychological domains (56 [56–63] vs 50 [50–63]), reduced in social relationships domain (31 [19–44] vs 44 [31–44]), remained same in environment domain (56 [44–69] vs 56 [56–56]). Seven patients showed improvement on Patients' Global Impression of Change scale, while six showed improvement on Clinical Global Impressions scale. These early results show that ultrasound guided distal GPN block can reduce pain intensity in oropharyngeal carcinoma patients.

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“…167 Nerve blocks using corticosteroids targeting the glossopharyngeal nerve in patients with tongue cancer can be considered if the pain is refractory to conventional medical therapy. 168 Evidence Evaluation and Best Practice Statement…”

Section: Evidence Evaluation and Best Practice Statementmentioning

confidence: 99%

The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain

Aman¹,

Mahmoud²,

Deer³

et al. 2021

JPR

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Moderate to severe pain occurs in many cancer patients during their clinical course and may stem from the primary pathology, metastasis, or as treatment side effects. Uncontrolled pain using conservative medical therapy can often lead to patient distress, loss of productivity, shorter life expectancy, longer hospital stays, and increase in healthcare utilization. Various publications shed light on strategies for conservative medical management for cancer pain and a few international publications have reviewed limited interventional data. Our multi-institutional working group was assembled to review and highlight the body of evidence that exists for opioid utilization for cancer pain, adjunct medication such as ketamine and methadone and interventional therapies. We discuss neurolysis via injections, neuromodulation including targeted drug delivery and spinal cord stimulation, vertebral tumor ablation and augmentation, radiotherapy and surgical techniques. In the United States, there is a significant variance in the interventional treatment of cancer pain based on fellowship training. As a first of its kind, this best practices and interventional guideline will offer evidenced-based recommendations for reducing pain and suffering associated with malignancy.

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Comparison of extraoral and intraoral routes of glossopharyngeal nerve block for pain relief in patient with carcinoma tongue

Cited by 5 publications

References 10 publications

Intraoperative Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Post-tonsillectomy Analgesia: A Case Report

Intraoperative Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Post-tonsillectomy Analgesia: A Case Report

Ultrasound-guided Glossopharyngeal Nerve Block—A New Paradigm in Pain Management

The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain

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