Kang H, Park S, Jin Y. Ultrasound-guided sphenopalatine ganglion block for effective analgesia during awake fiberoptic nasotracheal intubation: A case report. World J Clin Cases 2024; 12(14): 2451-2456 [PMID: 38765735 DOI: 10.12998/wjcc.v12.i14.2451]
Corresponding Author of This Article
Yehun Jin, MD, Professor, Department of Anesthesiology and Pain Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, South Korea. jessandjulia@naver.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2024; 12(14): 2451-2456 Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2451
Ultrasound-guided sphenopalatine ganglion block for effective analgesia during awake fiberoptic nasotracheal intubation: A case report
Hangil Kang, Seongjae Park, Yehun Jin
Hangil Kang, Seongjae Park, Yehun Jin, Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang-si 10408, Gyeonggi-do, South Korea
Author contributions: Jin Y designed the research; Kang H, Park S and Jin Y performed the research; Kang H and Jin Y analyzed the data and wrote the paper.
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Conflict-of-interest statement: The authors have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yehun Jin, MD, Professor, Department of Anesthesiology and Pain Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, South Korea. jessandjulia@naver.com
Received: February 20, 2024 Revised: March 13, 2024 Accepted: April 3, 2024 Published online: May 16, 2024 Processing time: 74 Days and 22 Hours
Abstract
BACKGROUND
Awake fiberoptic nasotracheal intubation (AFNI) is the preferred airway management strategy for patients with difficult airways. However, this procedure can cause significant physical and psychological distress. This case report explores the application of a sphenopalatine ganglion (SPG) block as an alternative analgesic modality to mitigate the discomfort associated with AFNI.
CASE SUMMARY
A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion. The patient’s medical history included prior surgery, chemotherapy, and radiation therapy, resulting in significant jaw impairment and limited neck mobility. Considering the anticipated airway challenges, AFNI was planned. A SPG block was performed under real-time ultrasound guidance, providing effective analgesia during nasotracheal intubation.
CONCLUSION
The SPG block represents a promising analgesic approach in AFNI, offering potential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.
Core Tip: This is the first clinical case report of the application of a sphenopalatine ganglion (SPG) block for awake fiberoptic nasotracheal intubation (AFNI). The SPG block provided sufficient analgesia during AFNI. This case report suggests that an alternative analgesic modality for AFNI is the most reasonable option for airway management.
