Use of peripheral nerve blocks in the treatment of trigeminal neuralgia may produce long-term pain relief, according to a study published in The American Journal of Emergency Medicine.
For the study, Michael Perloff, MD, Boston University School of Medicine, Boston, Massachusetts, and colleagues examined 9 patients with intractable primary trigeminal neuralgia who underwent peripheral trigeminal nerve blocks after failing conservative medical therapy.
The patients were injected with 0.5 mL of 0.25% bupivacaine and 1% lidocaine locally at the supraorbital, infraorbital, and mental foramens. Then, 1 mL of 0.25% bupivacaine and 1% lidocaine was injected in the region of the auriculotemporal nerve. All injections were done on the side with trigeminal neuralgia pain.
The researchers found that all 9 patients had immediate relief of their pain after the procedure, with most reporting that they were pain-free. In addition, 6 of the 9 patients noted continued pain relief from a range of 1 to 8 months following the procedure, with 2 of them having complete resolution of their pain months after the injections.
“Peripheral trigeminal nerve blocks can be a simple, safe alternative compared [with] opioids, invasive ganglion level procedures, or surgery,” concluded Dr. Perloff.