Abusawan Mahmoud, Ayyash Ahmad Abu, Ruzayqat Ahmed, Abukhalaf Muhammad M
From the Faculty of Medicine, Al-Quds University, Jerusalem, Palestine (MA, AAA, MMA), Anaesthesiology and Intensive Care Department (AR), Gastroenterology and Endoscopic Department, Al-Ahli Hospital, Hebron, Palestine (AAA).
Eur J Anaesthesiol Intensive Care. 2025 Jun 26;4(4):e0079. doi: 10.1097/EA9.0000000000000079. eCollection 2025 Aug.
Awake endoscopic retrograde cholangiopancreatography (ERCP) is infrequently performed, especially in patients with significant comorbidities. This case report documents the successful use of glossopharyngeal nerve block (GPNB) as the primary anaesthetic for an American Society of Anaesthesiologists (ASA) physical status class 4 male, 71 years old, with significant cardiac, pulmonary, and hepatobiliary comorbidities, who underwent awake ERCP with minimal intravenous sedation. The glossopharyngeal block effectively reduced the gag reflex and provided sufficient anaesthetic, allowing for the successful completion of ERCP without difficulties. The higher risk associated with general anaesthesia or deep sedation in this high-risk patient necessitated this approach.
清醒状态下的内镜逆行胰胆管造影术（ERCP）很少进行，尤其是在有严重合并症的患者中。本病例报告记录了成功使用舌咽神经阻滞（GPNB）作为一名美国麻醉医师协会（ASA）身体状况分级为4级的71岁男性患者的主要麻醉方法，该患者患有严重的心脏、肺部和肝胆合并症，在接受最小剂量静脉镇静的清醒状态下进行了ERCP。舌咽神经阻滞有效地降低了咽反射并提供了足够的麻醉效果，使得ERCP得以顺利完成，没有遇到困难。对于这名高危患者，全身麻醉或深度镇静相关的较高风险使得有必要采用这种方法。
