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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

A frequent problem with the intraoral glossopharyngeal block is finding a needle to use for the block. This problem can be easily overcome by using a 22-gauge disposable spinal needle. In an aseptic manner, the stylet is removed from the disposable spinal needle and discarded. Subsequently, using the sterile container in which the 22-gauge spinal needle was packaged, the distal 1 cm of the needle is bent to allow more control during submucosal insertion.

This block should be utilized more frequently than it is when airway anesthesia is needed for sedated, spontaneously ventilating, “awake” patients who require tracheal intubation. I believe that the block is effective in further reducing the gag reflex that results from pressure on the posterior third of the tongue, even after adequate topical mucosal anesthesia has been obtained.

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