Regional Nerve Blocks in Oculofacial Surgery

A new lacrimal neuralgia, a new nerve blockade procedure

“…They also had local tenderness at the emergence of the lacrimal nerve and experienced short-lasting relief upon anaesthetic blockade of the nerve. The technique employed for the nerve blockades was the same as that used in oculofacial surgery, with the needle inserted deeply along the lateral wall of the orbit (2,3). Here we report a third case of lacrimal neuralgia and a more simple method for blocking the lacrimal nerve.…”

Lacrimal Nerve Blocks for Three New Cases of Lacrimal Neuralgia

“…The two patients included in the earliest description underwent a deep intraorbital block as recommended for oculofacial surgery. 15,16 A 25-G needle was inserted through the upper eyelid along the lateral wall of the orbit, and the anesthetic solution was injected behind the lacrimal gland at a depth of approximately 2.5 cm. 1 The intervention allowed the diagnosis of lacrimal neuralgia, but only provided transient and short-lived pain relief.…”

Lacrimal neuralgia: So far, a missing cranial neuralgia

“…Indeed, a possible tenderness at the emergence or the course of the lacrimal nerve cannot be easily assessed. In addition, nerve blockades of this particular nerve are not easy to perform, since the anaesthetic has to be injected intraorbitally (14,15). All these circumstances may explain why lacrimal neuralgia has not been reported before.…”

“…An anaesthetic blockade of the lacrimal nerve was performed by injecting 0.5 cc of lidocaine 2% with a 25-gauge needle (Figure 2). The needle was inserted through the upper eyelid along the lateral wall of the orbit, and the anaesthetic solution was injected behind the lacrimal gland at a depth of approximately 2.5 cm (14,15). This procedure provided complete but transient pain relief, lasting around four hours.…”

“…A lumbar puncture showed an opening pressure of 14 cm of water, and the cerebrospinal fluid biochemical and cytological parameters were within normal ranges. Anaesthetic blockades of the left lacrimal nerve with lidocaine 2% (14,15) were performed on four different occasions, using the technique described above (Figure 2). Every time the nerve block resulted in complete but short-term relief lasting up to six hours.…”