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Local nerve block anesthesia for peroral endoscopy

T R DeMeester, D B Skinner, R H Evans

The Annals of Thoracic Surgery

|September 1, 1977

Summary

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Local anesthesia using glossopharyngeal and superior laryngeal nerve blocks provides effective pain control for peroral endoscopy. This technique ensures patient comfort and facilitates procedures like bronchoscopy and esophagoscopy with minimal complications.

Area of Science:

Anesthesiology
Gastroenterology
Pulmonology

Background:

Peroral endoscopic procedures require effective anesthesia for patient comfort and procedural success.
Traditional anesthesia methods may have limitations or side effects.

Purpose of the Study:

To evaluate the efficacy and safety of local glossopharyngeal and superior laryngeal nerve block anesthesia for peroral endoscopy.
To assess patient acceptance and procedural outcomes with this anesthetic technique.

Main Methods:

A total of 500 patients undergoing peroral endoscopy (including bronchoscopies, esophagoscopies, and combined procedures) received local glossopharyngeal and superior laryngeal nerve blocks.
The anesthetic technique aimed to abolish gag reflex and tactile sensation in relevant pharyngeal and laryngeal areas.

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Main Results:

Excellent anesthesia was achieved in the majority of patients, with good patient acceptance and minimal morbidity.
Inadequate anesthesia occurred in 2% (10/500) for glossopharyngeal block and a small percentage for superior laryngeal block during bronchoscopy.
The technique facilitated easy scope insertion and awake tracheal intubation.

Conclusions:

Local glossopharyngeal and superior laryngeal nerve block is a safe and effective anesthetic method for peroral endoscopy.
This technique offers a favorable alternative for procedures requiring airway access and conscious sedation.