Kang Hangil, Park Seongjae, Jin Yehun
Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang-si 10408, Gyeonggi-do, South Korea.
World J Clin Cases. 2024 May 16;12(14):2451-2456. doi: 10.12998/wjcc.v12.i14.2451.
Awake fiberoptic nasotracheal intubation (AFNI) is the preferred airway management strategy for patients with difficult airways. However, this procedure can cause significant physical and psychological distress. This case report explores the application of a sphenopalatine ganglion (SPG) block as an alternative analgesic modality to mitigate the discomfort associated with AFNI.
A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion. The patient's medical history included prior surgery, chemotherapy, and radiation therapy, resulting in significant jaw impairment and limited neck mobility. Considering the anticipated airway challenges, AFNI was planned. A SPG block was performed under real-time ultrasound guidance, providing effective analgesia during nasotracheal intubation.
The SPG block represents a promising analgesic approach in AFNI, offering potential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.
清醒纤维光导鼻气管插管（AFNI）是困难气道患者气道管理的首选策略。然而，该操作会引起明显的身体和心理不适。本病例报告探讨了蝶腭神经节（SPG）阻滞作为一种替代镇痛方式的应用，以减轻与AFNI相关的不适。
一名63岁女性，有右上颌骨肉瘤病史，因疑似恶性脑病变接受开颅手术。患者的病史包括既往手术、化疗和放疗，导致严重的颌部功能障碍和颈部活动受限。考虑到预期的气道挑战，计划进行AFNI。在实时超声引导下进行了SPG阻滞，在鼻气管插管期间提供了有效的镇痛。
SPG阻滞是AFNI中一种有前景的镇痛方法，在减轻涉及鼻腔和鼻咽区域的疼痛以及提高患者配合度方面具有潜在益处。
