Glossopharyngeal Nerve Block for the Management of Post-Tonsillectomy Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

UNLABELLED

To assess the effectiveness of glossopharyngeal nerve block (GNB) in the treatment of postoperative pain among patients undergoing tonsillectomy, a systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Various databases, including PubMed, Cochrane, Scopus, Web of Science, and Google Scholar, were systematically screened from inception until March 2023. The included studies were assessed using the RoB-2 tool. The outcomes of interest included reporting on at least one of the predetermined efficacy and safety endpoints, such as postoperative pain, the severity of swallowing, and the incidence of postoperative complications such as bleeding, nausea and vomiting, hoarseness, nasal obstruction, dyspnea, foreign body sensation, and dry mouth. Dichotomous data were collected as risk ratios (RR), and continuous data were collected as standardized mean differences (SMD). The overall analyses were conducted using a random-effects model. In total, 492 participants were enrolled in our investigation, with 245 and 247 participants allocated to the GNB and control arms, respectively. When comparing postoperative pain levels during rest and swallowing, the GNB arm showed a significantly reduced effect size compared to the control arm ( = 5 RCTs, SMD= -1.38, 95% CI [-1.82, -0.94],  < 0.001;  = 4 RCTs, SMD= -1.43, 95% CI [-2.15, -0.72],  < 0.001), respectively. Overall, there was no substantial variation in effect size between the GNB and control arms with regard to the severity of difficulty in swallowing ( = 0.7). Additionally, there were no significant differences observed between the GNB and control groups in terms of postoperative complications endpoints ( > 0.05). This thorough analysis showed that GNB had both statistical and clinical advantages for patients after a tonsillectomy. It was found that GNB was an effective, safe, and straightforward method for managing early postoperative pain.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12070-024-04928-w.