Local Anesthetic Blockade of Peripheral Nerves for Treatment of Neuralgias

Abstract

Because all reviewed articles were only single case reports or case series, no reliable conclusion could be drawn concerning the effectiveness of nerve blocks with local anesthetics in neuralgia. However, 2 features of the analyzed reports-the large magnitude of the effect and the high consistency of the reported outcome-indicate that future research efforts are warranted.

Postoperative Intractable Headache Resolving after Occipital Nerve Block

“…Not all observations can be accounted for by this mechanism. There are three phenomena associated with responses to nerve blocks described in the literature: pain relief may outlast the conduction blockade; block distal to the site of the pain inducing lesion may stop or alleviate the pain and blocking a peripheral nerve supplying a large part, but not the whole of the region of pain, may provide pain relief in the entire region [10,11].…”

Regional anesthesia in pain management

“…On a first glance, it seems irrational to expect a therapeutic effect by the injection of a local anesthetic, as the effect on nerve conduction is short lasting. However, a systematic review found consistent evidence for an effect of local anesthetic injections that exceeds the duration of the conduction blockade [26]. No study included in the review had negative results, but all reviewed articles were single case reports or case series, preventing reliable conclusions.…”

The sodium-channel blocker lidocaine in subanesthetic concentrations reduces spontaneous and evoked pain in human painful neuroma

“…Reports have suggested that anesthetic blocks as well as systemic administration of lidocaine may produce longlasting effects outlasting the conduction blockade and that blocks distally to the site of the nerve lesion may produce complete pain DOI relief [5,6], but the underlying mechanisms are unknown and properly controlled studies are lacking [4]. In the study by Miclescu et al some patients had an effect that lasted more than 24 h, but most patients had temporary, short-lasting effects [2].…”