The gagging reflex during dental treatment is a common concern for dentists and patients. Herein, we describe a novel approach to managing severe gagging reflex, termed the "KOJIMA program," using a systematic desensitization technique combined with an ultrasound-guided selective glossopharyngeal nerve block (UGSGNB). After performing the UGSGNB, the participants were trained to touch the inside of their mouths with a cotton swab.
View Article and Find Full Text PDFPurpose Postoperative pain management methods for tonsillectomy commonly include the use of opioids, non-steroidal anti-inflammatory drugs, and acetaminophen. However, some patients report pain despite the use of these medications. In recent years, ultrasound-guided selective glossopharyngeal nerve block (UGSGNB) and ultrasound-guided maxillary nerve block (UGMNB) have been reported to be effective for analgesia post-tonsillectomy.
View Article and Find Full Text PDFTonsillectomy can lead to significant postoperative pain, which can impact the recovery process. Traditional analgesic approaches may entail risks due to medication use. Considering that the tonsils are innervated by the glossopharyngeal and maxillary nerves, implementing glossopharyngeal and maxillary nerve blocks can provide analgesia.
View Article and Find Full Text PDFObjective: Glossopharyngeal nerve block is a useful interventional technique for pain management of the head and neck. It is performed with landmark techniques or ultrasound guidance. We propose a novel ultrasound-guided glossopharyngeal nerve block technique.
View Article and Find Full Text PDFA 74-year-old male was diagnosed with osteomyelitis of the left mandible requiring marginal mandibulectomy under general anesthesia. However, the patient's pulmonary function tests demonstrated findings consistent with severe chronic obstructive pulmonary disease, classified as stage III. The consulting pulmonologist explained the increased risk of respiratory complications associated with general anesthesia and advised against its use.
View Article and Find Full Text PDFA 54-year-old man with squamous cell carcinoma of the tongue underwent bilateral cervical lymph node dissection, total tongue resection, forearm flap reconstruction, and tracheostomy. The plan was to replace the oral endotracheal tube (ETT) with a cuffed tracheostomy tube at the end of the surgical case while the patient was still under general anesthesia. No major complications were expected as the tracheal foramen was visible once surgical access was obtained.
View Article and Find Full Text PDFWe report a case of ultrasound-guided craniocervical nerve blocks performed with ropivacaine for perioperative local/regional anesthesia in a patient who underwent right partial maxillary resection and neck dissection under general anesthesia. The patient was an 85-year-old woman with multiple medical comorbidities in whom analgesia using nonsteroidal anti-inflammatory drugs and opioids was expected to increase the risk of postoperative complications. Bilateral ultrasound-guided maxillary (V2) nerve blocks and a right superficial cervical plexus block were performed, which provided adequate perioperative anesthesia and avoided postoperative complications.
View Article and Find Full Text PDFHead and neck reconstructive surgery involving tissue flaps is often complex requiring the development of an individualized anesthetic plan. The following case report describes the anesthetic management of an 87-year-old man considered at high risk for postoperative delirium due to advanced age and blindness undergoing general anesthesia for resection of squamous cell carcinoma of the right side of the nose and reconstructive surgery with a scalping forehead flap. Ultrasound-guided local anesthetic maxillary and supraorbital nerve blocks were successfully used perioperatively to reduce the need for alternative analgesics associated with higher risks of complications such as postoperative nausea, vomiting, and delirium.
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