The glossopharyngeal nerve block (GPNB) is used primarily for surgical procedures but has been used in pain management in cases of neuralgia as well as to abolish the gag reflex for anesthetic, endoscopic, or dental procedures.
- Place the patient in supine position or reclined in a dental chair.
- Place the index finger of your left hand over a line joining the ipsilateral mastoid process and angle of the mandible, palpating the styloid process if palpable.
- Retract the tongue medially and caudally if required.
- Holding the syringe with a pen grasp in your right hand, gently insert the needle into the area between the base of the ipsilateral anterior and posterior tonsillar pillar, resting the syringe in between the contralateral maxillary premolar teeth and pointing it toward your opposite index finger
- The needle should be inserted to a depth of 0.5 cm. Aspirate in two planes and inject 1 to 2 mL of the anesthetic solution. In case of positive aspiration or headache during injection, draw the needle and repeat the procedure.
- The patient was placed in the supine position, and an imaginary line was visualized running from the mastoid process to the angle of the mandible.
- The styloid process should lie just below the midpoint of the line.
- The skin was prepared with an antiseptic solution.
- A 22 gauge, 1.5‑inch needle attached to a 10 mL syringe, was advanced through this midpoint location in the plane perpendicular to the skin.
- The styloid process was encountered within 3 cm after contact was made and then the needle was withdrawn and “walked off” the styloid process posteriorly.
- As soon as bony contact was lost, and if careful aspiration revealed no blood or cerebrospinal fluid, 4 mL of 0.5% bupivacaine combined with 1 mL (40 mg) of triamcinolone acetonide was injected in incremental dosage.
Rao, S., & Rao, S. (2018). Glossopharyngeal Nerve Block: The Premolar Approach. Craniomaxillofacial trauma & reconstruction, 11(4), 331–332. https://doi.org/10.1055/s-0037-1606249.
Singh N, Singh S, Mishra NK, Kumar V; Hemlata, Gautam S. Comparison of extraoral and intraoral routes of glossopharyngeal nerve block for pain relief in patient with carcinoma tongue: A prospective randomized study. J Cancer Res Ther. 2020 Apr-Jun;16(3):534-538. doi: 10.4103/jcrt.JCRT_309_18. PMID: 32719263.