Efficacy of glossopharyngeal nerve block in managing pain in head and neck cancer: a retrospective cohort study.

BACKGROUND

Head and Neck Cancer (HNC) causes severe pain from tumor invasion, nerve involvement, and treatment effects. Conventional analgesia, including opioids, may be inadequate or poorly tolerated. Glossopharyngeal nerve block (GNB) offers targeted relief, though evidence in cancer pain is limited.

METHODS

This retrospective cohort study evaluated efficacy and safety of GNB in HNC patients. Eighty-two patients with refractory pain received GNB using 2.2 mL of 40 mg triamcinolone 5 mg bupivacaine via peristyloid or pharyngeal wall approach under ultrasound guidance. Pain was assessed using the Numeric Rating Scale (NRS) at baseline, 15 minutes, 1 day, 1 week, 1 month, and 3 months post-procedure. Opioid use (morphine-equivalent daily dose, MEDD), duration of relief, and complications were recorded.

RESULTS

Baseline NRS score of 8.76 ± 0.88 decreased to 0.98 ± 1.05 at 15 minutes and remained low at 3 months (3.17 ± 1.89; p < 0.0001). At 15 minutes, 98.8% achieved ≥50% pain relief; 81.7% maintained it at 3 months. MEDD dropped from 86.95 mg to 31.87 mg/day (p < 0.0001). Fourteen patients required repeat blocks. Three patients experienced minor transient adverse events.

CONCLUSION

Ultrasound-guided GNB offers rapid, sustained pain relief and reduces opioid use in HNC, showing a favorable safety profile.