舌咽神经阻滞在扁桃体切除术后镇痛中的临床应用研究

Research progress on the clinical application of glossopharyngeal nerve block in analgesia after tonsillectomy

扁桃体切除术和腺样体扁桃体切除术是耳鼻咽喉科最常见的手术之一,手术操作导致的局部炎症和神经刺激所引发的术后疼痛是该类手术后的常见并发症,严重影响患者术后生活质量及满意度。目前用于术后镇痛的主要有各种类型的镇痛药物(阿片类药物、类固醇、非甾体类抗炎药等)、局部麻醉喷雾及局部浸润麻醉。舌咽神经是支配扁桃体和扁桃体周围感觉的主要神经,因此阻滞该神经可以达到镇痛的目的。关于舌咽神经阻滞(GNB)减轻扁桃体术后疼痛的研究近年逐渐增多,现针对该技术的镇痛原理、阻滞方法、镇痛效果等方面进行综述。

Tonsillectomy and adenoid tonsillectomy are one of the most common operations in otolaryngology.The postoperative pain caused by local inflammation and nerve stimulation triggered by the operation is a common complication after this type of operation,which seriously affects the postoperative quality of life and satisfaction of patients.At present,various types of analgesics(opioids,steroids,non-steroidal anti-inflammatory drugs,etc.),local anesthetic spray and local infiltration anesthesia are mainly used for postoperative analgesia.The glossopharyngeal nerve is the main nerve that innervates the tonsils and sensation around the tonsils.Therefore,blocking this nerve can achieve the purpose of analgesia.In recent years,more and more studies have been done to block glossopharyngeal nerve to relieve pain after tonsillectomy.This paper reviews the analgesic principle,blocking method and analgesic effect of this technique.