Objective: To demonstrate glossopharyngeal nerve block by local anesthetics on post-tonsillectomy pain management
Patients and Methods: Two hundred and ten children aged seven to fifteen underwent elective tonsillectomy after parents documented agreement,  divided into two equal groups—one hundred and five candidates in each chosen group,  from Minia university hospital,   otorhinolaryngology outpatient clinic. Group A: received glossopharyngeal nerve block ( intra-oral approach ), using bupivacaine 0.5% ( 1mg/kg divided in both sides) immediately after endotracheal intubation (pre-incisional). Group B:  received 5 ml sterile saline on each side. Chronic tonsillitis was the indication of tonsillectomy in our study.
Results: Glossopharyngeal nerve block can decrease postoperative pain scores. VAS (Visual Analogue Scale ) was higher in group B, compared to group (A) up to 24 hours postoperative. Time for the first need for pain killer was delayed in the group (A) compared to group (B), (P < 0.0001).  The postoperative dose of rescue analgesia consumed in group (A) was lower than in the control group (P < 0.0001).  The time of first oral intake was prolonged in the group (B) compared to group (A)(P < 0.0001). Patients that needed additional analgesia represented 30 % of the group(A) and 62 % in the group (B).  The pattern of sleep during the first post-operative night was good in the group (A) in comparison with  group (B) (P = 0.003 ). No secondary hemorrhage  was reported in both groups
Conclusion: Glossopharyngeal nerve block with bupivacaine (0.5%) significantly reduces postoperative analgesic use, and delays the time for the first need for a rescue pain killer.