Analgesia, Recovery, Psychological
Conditions
Brief summary
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.
Detailed description
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.
Interventions
PROCEDUREGlossopharyngeal nerve block
Glossopharyngeal nerve block using ultrasound guidance after induction of general anesthesia plus topical anesthesia before surgical incision.
The patient will receive intravenous fentanyl and non opioids analgesics (acetaminophen and non-steroidal anti-inflammatory drugs) with general anesthesia.
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Confirmed diagnosis of moderate to severe obstructive sleep apnea. * Patients scheduled for elective palatoplasty under general anesthesia. * American Society of Anesthesiologists Physical Status class I and II.
Exclusion criteria
* Patients with chronic opioid use. * Advanced hepatic, renal, cardiovascular, and neurologic diseases.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The recovery time | 1 hour | The time from from inhalational anesthetic discontinuation to the first response to verbal command. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Additional intraoperative analgesia | 4 hours | Additional doses of intraoperative fentanyl. |
| Postoperative pain assessment | The first 24 hours postoperative. | 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. |
| Total rescue analgesia | The first 24 hours postoperative. | Total rescue analgesic dose needed during the first postoperative 24 hours. |
| Incidence of complications | 4 hours | Incidence of any complications related to nerve block or local anesthesia such as hematoma formation or local anesthetic systemic toxicity. |
| Quality of recovery | The first 24 hours postoperative. | 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. |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORFatma Mahmoud Ahmed, MD
Department of Anesthesia, Intensive Care & Pain Management, Zagazig University
STUDY_DIRECTORAlshaimaa Abdelfattah Kamel, MD
Department of Anesthesia, Intensive Care & Pain Management, Zagazig University
STUDY_DIRECTOROsama Yehia Khalifa, MD
Department of Anesthesia, Intensive Care & Pain Management, Zagazig University
Outcome results
None listed