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Obstructive sleep apnea is a prevalent condition often treated surgically with palatoplasty, which improves airway patency and reduces apneic events. However, postoperative pain and airway discomfort following palatoplasty can be significant, leading to delayed oral intake, increased opioid consumption, and prolonged recovery. Combining an ultrasound-guided glossopharyngeal nerve block with topical airway anesthesia may provide synergistic analgesia and support a safer recovery profile.
Obstructive sleep apnea is a prevalent condition often treated surgically with palatoplasty, which improves airway patency and reduces apneic events. However, postoperative pain and airway discomfort following palatoplasty can be significant, leading to delayed oral intake, increased opioid consumption, and prolonged recovery. Enhanced Recovery After Surgery protocols aim to accelerate functional recovery and reduce perioperative morbidity. Combining an ultrasound-guided glossopharyngeal nerve block with topical airway anesthesia may provide effective analgesia and support a smoother recovery profile.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Active Comparator | The patient will receive the ultrasound-guided glossopharyngeal nerve block combined with topical airway anesthesia. |
|
| Group c | Active Comparator | The patient will receive the standard multimodal analgesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glossopharyngeal nerve block | Procedure | Glossopharyngeal nerve block using ultrasound guidance after induction of general anesthesia plus topical anesthesia before surgical incision. |
| Measure | Description | Time Frame |
|---|---|---|
| The recovery time | The time from from inhalational anesthetic discontinuation to the first response to verbal command. | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Additional intraoperative analgesia | Additional doses of intraoperative fentanyl. | 4 hours |
| Postoperative pain assessment | Postoperative pain assessment by the 10 points Visual Analogue Scale at at rest and during swallowing with 0 indicates no pain and 10 indicates the worst pain. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Fatma Mahmoud Ahmed, MD | Department of Anesthesia, Intensive Care & Pain Management, Zagazig University | Principal Investigator |
| Alshaimaa Abdelfattah Kamel, MD | Department of Anesthesia, Intensive Care & Pain Management, Zagazig University | Study Director |
| Osama Yehia Khalifa, MD | Department of Anesthesia, Intensive Care & Pain Management, Zagazig University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zagazig university hospital | Zagazig | Al-Sharkia | 44519 | Egypt |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Standard multimodal analgesia | Other | The patient will receive intravenous fentanyl and non opioids analgesics (acetaminophen and non-steroidal anti-inflammatory drugs) with general anesthesia. |
|
| The first 24 hours postoperative. |
| Total rescue analgesia | Total rescue analgesic dose needed during the first postoperative 24 hours. | The first 24 hours postoperative. |
| Incidence of complications | Incidence of any complications related to nerve block or local anesthesia such as hematoma formation or local anesthetic systemic toxicity. | 4 hours |
| Quality of recovery | Quality of recovery assessed by the Quality of recovery score-15 at the end of the first 24 hours postoperative. The Quality of recovery score ranges from 0 to150, with higher scores indicate better recovery. | The first 24 hours postoperative. |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |