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In children undergoing tonsillectomy, glossopharyngeal nerve block with Bupivacaine decreases postoperative pain.
A recent study reported that in children scheduled to undergo elective tonsillectomy, the use of glossopharyngeal nerve block using 0.5% Bupivacaine remarkably reduced postoperative pain and analgesic use, and also delayed the time for the first need for a rescue pain killer. Researchers sought to explore glossopharyngeal nerve block by local anesthetics to alleviate post-tonsillectomy pain.
A total of 210 children (age 7-15 years) were segregated into two equal groups (105 candidates in each group). Group A was treated with glossopharyngeal nerve block (intra-oral approach) using 0.5% Bupivacaine (1 mg/kg segregated in both sides) immediately following endotracheal intubation (pre-incisional). Group B was treated with 5 ml sterile saline on each side. In this study, chronic tonsillitis was the indication of tonsillectomy.
Glossopharyngeal nerve block decreased postoperative pain scores. After surgery, VAS (Visual Analogue Scale) was higher in group B when compared to group A for up to 24 hours. Compared to group B, group A exhibited delayed time for the first need for pain killer, reduced intake of postoperative dose of rescue analgesia, decreased time of first oral intake, and better pattern of sleep during the first post-operative night.
Notably, 30% of people in Group A and 62% of people in Group B needed additional analgesia. In both groups, no secondary hemorrhage was noted. Thus, glossopharyngeal nerve block appears to be beneficial for post-tonsillectomy pain management.
Egyptian Journal of Neck Surgery and Otorhinolaryngology
Glossopharyngeal Nerve block on post-tonsillectomy pain among Egyptian children
Bassem Saied Abdallah Saied et al.
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