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

Abstract

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.

Keywords

• glossopharyngeal nerve
• nerve block
• ultrasonography