Glossopharyngeal Block

Published on 06/02/2015 by admin

Last modified 06/02/2015

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28 Glossopharyngeal Block

Perspective

Glossopharyngeal block is useful for anesthesia of the mucosa of the pharynx and soft palate as well as for eliminating the gag reflex that results when pressure is applied to the posterior third of the tongue.

Patient Selection

Glossopharyngeal block can be used in most patients who need atraumatic, sedated, spontaneously ventilating, “awake” tracheal intubation.

Pharmacologic Choice

The local anesthetic chosen for glossopharyngeal block does not need to provide motor blockade. Lidocaine (0.5%) is an appropriate choice of local anesthetic.

Placement

The glossopharyngeal nerve exits from the jugular foramen at the base of the skull, as illustrated in Figure 28-1, in close association with other structures of the carotid sheath, vagus nerve, and styloid process. The glossopharyngeal nerve descends in the neck, passes between the internal carotid and the external carotid arteries, and then divides into pharyngeal branches and motor branches to the stylopharyngeus muscle as well as branches innervating the area of the palatine tonsil and the posterior third of the tongue. These distal branches of the glossopharyngeal nerve are located submucosally immediately posterior to the palatine tonsil, deep to the posterior tonsillar pillar.