Clinical effectiveness of peripheral nerve blocks with lidocaine and corticosteroid in patients with trigeminal neuralgia

Abstract

Objectives: Clinical efficacy of easily applicable peripheral nerve blocks has been in interest except open and closed surgical procedures requiring advanced equipment. We aimed to evaluate the clinical efficacy of triamcinolone and lidocaine injection for peripheral nerve branches in trigeminal neuralgia in terms of pain severity, pain frequency, and drug doses used. Methods: This study was a retrospective cohort study. A total of 72 patients with trigeminal neuralgia, who underwent peripheric trigeminal nerve injection with lidocaine and triamcinolone between 2011-2018 were included. Pain severity, pain frequency, changes in carbamazepine equivalent doses, and pregabalin equivalent doses were evaluated. We also evaluated whether there was a correlation between the success of the procedure and independent variables. Results: There was a statistically significant difference in pain intensity and frequency between baseline and post-procedure at 1, 3, and 6 mo (p=0.000). There was a statistically significant difference between carbamazepine equivalent doses at baseline, and 3, and 6 mo after the procedure (p=0.002, 0.005 respectively). Two complications were evaluated, 1 patient had prolonged painless paresthesia related to the procedure area lasting about 1 week and 2 patients had ecchymosis at the procedure area. Conclusion: The injection of lidocaine and corticosteroid combination for peripheral branches of the trigeminal nerve may result in short and mid-term clinical relief. Peripheral nerve blocks may be preferred for short-medium-term pain management with rare complications and simple device requirements also need little experience and skills.

Evaluation of the effectiveness duration of peripheral blocks applied with high concentration local anesthetic and steroid in trigeminal neuralgia

“…[18] A recent study of peripheral block using lidocaine and triamcinolone in trigeminal neuralgia highlighted the short-to-medium-term efficacy of peripheral blocks. [19] The use of steroids adjuvant effectively with local anesthetics in peripheral blocks causes vasoconstriction and prolongs the duration of action by reducing local anesthetic absorption, and increases the activity of inhibitory potassium channels on nociceptive C fibers and changes the membrane lipid phase balance. [20] All eight patients who benefited from the peripheral block and applied RFT afterward had ≥50% pain reduction and the average efficacy duration was 22.75 months.…”