Bell K R, Cyna A M, Lawler K M, Sinclair C, Kelly P J, Millar F, Flood L M
Department of Anaesthetics, South Cleveland Hospital, Middlesbrough, UK.
Anaesthesia. 1997 Jun;52(6):597-602. doi: 10.1111/j.1365-2222.1997.131-az0127.x.
This controlled, randomised, double-blind study compared whether glossopharyngeal nerve block and intravenous morphine administered peri-operatively, decreased pain following elective adult tonsillectomy and uvulopalatoplasty more than morphine alone. Sixteen of 30 patients undergoing uvulopalatoplasty and 38 of 78 patients having tonsillectomy received bilateral glossopharyngeal nerve blocks, using bupivacaine 0.5% and adrenaline 1:200,000, or no intervention. There were no differences in postoperative analgesic consumption between the two groups. Visual analogue pain scores measured during swallowing in the recovery room and on the ward postoperatively were significantly less overall in uvulopalatoplasty patients who had received a block (p = 0.004). This difference was not found for tonsillectomy. We found no significant differences between groups, in pain scores recorded during the first 5 days at home. We conclude that glossopharyngeal block does not improve analgesia following tonsillectomy although there is short-lived benefit following uvulopalatoplasty.
这项对照、随机、双盲研究比较了围手术期给予舌咽神经阻滞和静脉注射吗啡，与单纯使用吗啡相比，是否能更有效地减轻择期成人扁桃体切除术和悬雍垂腭咽成形术后的疼痛。接受悬雍垂腭咽成形术的30例患者中有16例，接受扁桃体切除术的78例患者中有38例接受了双侧舌咽神经阻滞，使用0.5%布比卡因和1:200,000肾上腺素，或未接受干预。两组术后镇痛药物的消耗量没有差异。在恢复室吞咽时以及术后病房中测量的视觉模拟疼痛评分显示，接受阻滞的悬雍垂腭咽成形术患者总体上显著更低（p = 0.004）。扁桃体切除术患者未发现这种差异。我们发现，在家中头5天记录的疼痛评分在两组之间没有显著差异。我们得出结论，舌咽神经阻滞并不能改善扁桃体切除术后的镇痛效果，尽管悬雍垂腭咽成形术后有短期益处。
