The effects of glossopharyngeal nerve block on postoperative pain relief after tonsillectomy: the importance of the extent of obtunded gag reflex as a clinical indicator.
BACKGROUND
We evaluated the efficacy of glossopharyngeal nerve block (GNB) for the control of post-tonsillectomy pain in adult patients, and correlated the extent of obtunded gag reflex as a clinical indicator of GNB with the extent of pain relief.


METHODS
Seventy-five patients undergoing tonsillectomy received bilateral GNB with 0.75% ropivacaine with epinephrine (Group R), 0.5% bupivacaine with epinephrine (Group B) at the end of the operation, or no intervention (Group C). To evaluate the effects of GNB, we assessed throat pain (100 mm visual analog scale) and severity of gag reflex response 0.5, 8, and 24 h after surgery.


RESULTS
In the immediate postoperative period, pain scores at rest and when swallowing in Groups R and B were significantly lower than those in Group C (21 +/- 17 and 23 +/- 13 vs 42 +/- 16, 28 +/- 22 and 32 +/- 19 vs 62 +/- 14, P < 0.001). The analgesic effect of GNB was strongly correlated with the extent of obtunded gag reflex (P < 0.01).


CONCLUSIONS
GNB is a useful method for the palliation of post-tonsillectomy pain. An obtunded gag reflex response may be a clinical indicator for analgesia from GNB.
Park
Hee-Pyoung
HP
Department of Anesthesia and Pain Medicine, Seoul National University Bundang Hospital, Gumi-dong, Bundang-gu, Seongnam-si, Korea.
Hwang
Jung-won
JW
Park
Sang-Hyun
SH
Jeon
Young-Tae
YT
Bahk
Jae-Hyon
JH
Oh
Yong-Seok
YS
D000328:Adult; D005260:Female; D005683:Gagging / Q000502:physiology*; D005930:Glossopharyngeal Nerve / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014068:Tonsillectomy