A randomized control trial to study the effect of bilateral Gow-gates block on visibility of surgical field and hemodynamic response in patients with carcinoma tongue. (2022)

• Record Type: Journal Article
• Authors: Brahmanandan, Radhikadevi; Thomas, Mary; Jagathnath Krishna, K.M
• Is Part Of: Cancer treatment and research communications. Number 31(2022)
• Publication Date: 2022
• Subjects: Carcinoma tongue -- Head and neck cancer -- Nerve block -- Analgesia -- Morphine -- Hemodynamics
• DOI: 10.1016/j.ctarc.2022.100535
• Languages: English
• ISSNs: 2468-2942

Abstract

Highlights: Bilateral gowgates block combined with general anesthesia help to reduce the hemodynamic stress response during excision and thereby improve surgical field visibility in early cancer tongue surgeries than IV morphine alone. Reductions in adrenergic stress response with regional blocks favor the surgical outcome over a long-term period. Excellent analgesia offered by the block help to reduce the intraoperative and postoperative need of morphine. Abstract: Background and Aims: Regional anesthesia in oncosurgery is a current research topic. The use of nerve blocks near the surgical site gives good analgesia, surgical field visibility and hemodynamic profile. Our aim was to evaluate the effect of the Gow gate mandibular nerve block in tongue surgeries. Methods: ASA 1 & 2 patients posted for surgery for carcinoma of tongue were included in the study. After randomization Bilateral Gowgates block was given to Group G. Group M received IV Morphine only. The investigator B who was blinded to which group the patient belonged conducted the anesthesia and did the outcome assessment. The hemodynamic response to surgical manipulation was noted. The visibility of the surgical field was assessed by the surgeon using Surgical visibility scale. Postoperative pain was assessed by assessing dose requirement of opioids and paracetamol. The mean difference between the two groups were tested using student's t -test for normally distributed variables and Mann-Whitney U test for non-normal variables. Results: Hemodynamic stress response during surgical stimulation was significantly lower in group G. Surgical field visibility score was better in the group G ( p 0.002). The use of morphine intraoperatively in group G was less ( p = 0.001) Conclusion: Bilateral Gow gates block improves visibility of surgical field and hemodynamic response in patients undergoing surgery for carcinoma tongue.