Enhanced Recovery After Uvulopalatoplasty

Combined Glossopharyngeal Nerve Block With Topical Anesthesia for Enhanced Recovery in Obstructive Sleep Apnea Patients Undergoing Uvulopalatoplasty

Obstructive sleep apnea is a prevalent condition often treated surgically with palatoplasty, which improves airway patency and reduces apneic events. However, postoperative pain and airway discomfort following palatoplasty can be significant, leading to delayed oral intake, increased opioid consumption, and prolonged recovery. Combining an ultrasound-guided glossopharyngeal nerve block with topical airway anesthesia may provide synergistic analgesia and support a safer recovery profile.

Study Overview

• Status: Active, not recruiting
• Conditions: Analgesia; Recovery, Psychological
• Intervention / Treatment: Procedure: Glossopharyngeal nerve block; Other: Standard multimodal analgesia

Detailed Description

Obstructive sleep apnea is a prevalent condition often treated surgically with palatoplasty, which improves airway patency and reduces apneic events. However, postoperative pain and airway discomfort following palatoplasty can be significant, leading to delayed oral intake, increased opioid consumption, and prolonged recovery. Enhanced Recovery After Surgery protocols aim to accelerate functional recovery and reduce perioperative morbidity. Combining an ultrasound-guided glossopharyngeal nerve block with topical airway anesthesia may provide effective analgesia and support a smoother recovery profile.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Al-Sharkia
    • Zagazig, Al-Sharkia, Egypt, 44519
      • Zagazig university hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Confirmed diagnosis of moderate to severe obstructive sleep apnea.
• Patients scheduled for elective palatoplasty under general anesthesia.
• American Society of Anesthesiologists Physical Status class I and II.

Exclusion Criteria:

• Patients with chronic opioid use.
• Advanced hepatic, renal, cardiovascular, and neurologic diseases.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group I; The patient will receive the ultrasound-guided glossopharyngeal nerve block combined with topical airway anesthesia.	Procedure: Glossopharyngeal nerve block; Glossopharyngeal nerve block using ultrasound guidance after induction of general anesthesia plus topical anesthesia before surgical incision.
Active Comparator: Group c; The patient will receive the standard multimodal analgesia.	Other: Standard multimodal analgesia; The patient will receive intravenous fentanyl and non opioids analgesics (acetaminophen and non-steroidal anti-inflammatory drugs) with general anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The recovery time	The time from from inhalational anesthetic discontinuation to the first response to verbal command.	1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Additional intraoperative analgesia	Additional doses of intraoperative fentanyl.	4 hours
Total rescue analgesia	Total rescue analgesic dose needed during the first postoperative 24 hours.	The first 24 hours postoperative.
Incidence of complications	Incidence of any complications related to nerve block or local anesthesia such as hematoma formation or local anesthetic systemic toxicity.	4 hours
Postoperative pain assessment	Postoperative pain assessment by the 10 points Visual Analogue Scale at at rest and during swallowing with 0 indicates no pain and 10 indicates the worst pain.	The first 24 hours postoperative.
Quality of recovery	Quality of recovery assessed by the Quality of recovery score-15 at the end of the first 24 hours postoperative. The Quality of recovery score ranges from 0 to150, with higher scores indicate better recovery.	The first 24 hours postoperative.

Collaborators and Investigators

• Sponsor: Zagazig University
• Investigators: Principal Investigator: Fatma Mahmoud Ahmed, MD, Department of Anesthesia, Intensive Care & Pain Management, Zagazig University; Study Director: Alshaimaa Abdelfattah Kamel, MD, Department of Anesthesia, Intensive Care & Pain Management, Zagazig University; Study Director: Osama Yehia Khalifa, MD, Department of Anesthesia, Intensive Care & Pain Management, Zagazig University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): April 1, 2027

Study Registration Dates

• First Submitted: November 17, 2025
• First Submitted That Met QC Criteria: November 17, 2025
• First Posted (Actual): November 24, 2025

Study Record Updates

• Last Update Posted (Actual): May 6, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Agnosia
• Other Study ID Numbers: Uvulopalatoplasty Analgesia

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No