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

Author:

Yadav Mukesh K.1,Pulappadi Vishnu Prasad1ORCID,Singh Vikram Pratap2,Bharati Sachidanand J2,Bagga Barun13

Affiliation:

1. Departments of Radiodiagnosis & Interventional Radiology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

2. Departments of Onco-anaesthesiology & Palliative Medicine, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

3. New York University School of Medicine, New York, United States

Abstract

AbstractWe 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.

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

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