{"title":"超声引导下选择性舌咽神经阻滞:下颌后支入路。","authors":"Yuki Kojima, Songi Okamoto, Kazuya Hirabayashi","doi":"10.1093/pm/pnad143","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique.</p><p><strong>Methods: </strong>This new approach was performed in 3 patients in their twenties and thirties. A needle was inserted deeply under the stylohyoid muscle through the sternocleidomastoid muscle. Subsequently, an ultrasound-guided nerve block was performed with 1 mL of 1% xylocaine. The performance of our technique was evaluated with 2 tests: a cold sensitivity test and a gag reflex test.</p><p><strong>Results: </strong>The effect of the nerve block was observed in the posterior third of the tongue on both sides, the tonsils, and the pharyngeal region. The effect lasted for approximately 1.5 hour. Motor efferent block was not observed.</p><p><strong>Conclusions: </strong>We designated the technique as ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach. No complications occurred during the bilateral application. This novel approach can be performed at a very shallow position, compared with conventional methods. There is no damage to tissues other than the muscles, which reduces postoperative complications and patient distress. Although our technique requires further safety assessments and technical refinements, it could represent a simpler alternative to conventional methods in daily clinical practice.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach.\",\"authors\":\"Yuki Kojima, Songi Okamoto, Kazuya Hirabayashi\",\"doi\":\"10.1093/pm/pnad143\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique.</p><p><strong>Methods: </strong>This new approach was performed in 3 patients in their twenties and thirties. A needle was inserted deeply under the stylohyoid muscle through the sternocleidomastoid muscle. Subsequently, an ultrasound-guided nerve block was performed with 1 mL of 1% xylocaine. The performance of our technique was evaluated with 2 tests: a cold sensitivity test and a gag reflex test.</p><p><strong>Results: </strong>The effect of the nerve block was observed in the posterior third of the tongue on both sides, the tonsils, and the pharyngeal region. The effect lasted for approximately 1.5 hour. Motor efferent block was not observed.</p><p><strong>Conclusions: </strong>We designated the technique as ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach. No complications occurred during the bilateral application. This novel approach can be performed at a very shallow position, compared with conventional methods. There is no damage to tissues other than the muscles, which reduces postoperative complications and patient distress. Although our technique requires further safety assessments and technical refinements, it could represent a simpler alternative to conventional methods in daily clinical practice.</p>\",\"PeriodicalId\":19744,\"journal\":{\"name\":\"Pain Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/pm/pnad143\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/pm/pnad143","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:舌咽神经阻滞是一种有效的头颈部疼痛介入治疗技术。它是使用标志性技术或超声波引导进行的。我们提出了一种新的超声引导舌咽神经阻滞技术。方法:在20多岁的3名患者中采用了这种新方法 s-30s。一根针通过胸锁乳突肌深深地插入到笔舌骨肌下面。随后,用1 mL 1%的利多卡因。我们的技术性能通过两项测试进行了评估:冷敏感性测试和呕吐反射测试。结果:神经阻滞在两侧舌后1/3、扁桃体和咽区均有效果。这种影响持续了大约1.5 h.未观察到运动传出阻滞。结论:我们将该技术指定为超声引导下的选择性舌咽神经阻滞:下颌后支入路。双侧应用期间未出现并发症。与传统方法相比,这种新方法可以在非常浅的位置执行。除肌肉外,其他组织没有损伤,这减少了术后并发症和患者痛苦。尽管我们的技术需要进一步的安全性评估和技术改进,但在日常临床实践中,它可能是传统方法的一种更简单的替代方案。
Objective: Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique.
Methods: This new approach was performed in 3 patients in their twenties and thirties. A needle was inserted deeply under the stylohyoid muscle through the sternocleidomastoid muscle. Subsequently, an ultrasound-guided nerve block was performed with 1 mL of 1% xylocaine. The performance of our technique was evaluated with 2 tests: a cold sensitivity test and a gag reflex test.
Results: The effect of the nerve block was observed in the posterior third of the tongue on both sides, the tonsils, and the pharyngeal region. The effect lasted for approximately 1.5 hour. Motor efferent block was not observed.
Conclusions: We designated the technique as ultrasound-guided selective glossopharyngeal nerve block: posterior mandibular ramus approach. No complications occurred during the bilateral application. This novel approach can be performed at a very shallow position, compared with conventional methods. There is no damage to tissues other than the muscles, which reduces postoperative complications and patient distress. Although our technique requires further safety assessments and technical refinements, it could represent a simpler alternative to conventional methods in daily clinical practice.
期刊介绍:
Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.