Combination of pharmacotherapy and lidocaine analgesic block of the peripheral trigeminal branches for trigeminal neuralgia: a pilot study

Stani, F. Di; Ojango, Christine; D, De Santis; Lorenzo, Luigi Di; Masala, Salvatore; Delfini, Roberto; Bruti, G.; Simonetti, Giovanni; Piovesan, Élcio Juliato; Ruggeri, Andrea

doi:10.1590/0004-282x20150077

Cited by 17 publications

(12 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with the literature, our study also showed that peripheral nerve injections were safe in terms of side effects and complications. [13][14][15][16] One of the limitations of our study is its retrospective design. Prospective randomized controlled studies with long-term follow-up may clarify the clinical efcacy of peripheral nerve blocks in trigeminal neuralgia and help to identify the factors realted with clinical success.…”

Section: Discussionmentioning

confidence: 98%

“…Similar results have been shown in the case series in which peripheral nerve blocks were evaluated in 3-9 patients with trigeminal neuralgia, consistent with the clinical efficacy that may extend up to 6 mo. [13][14][15] Stani et al [16] demonstrated that the combination of lidocaine injection for the peripheral branches of the trigeminal nerve with pharmacological therapy was superior to pharmacological therapy in the short term follow-up. Bainton et al showed a prolonged clinical response of peripheral nerve blocks was associated with neurotoxicity of local anesthetics.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Balta

Talu

2021

Agri

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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

Balta

Talu

2021

Agri

View full text Add to dashboard Cite

show abstract

“…In only one randomized study, quality of life was investigated in 13 patients suffering from trigeminal pain 10 . Six patients received TNB using 2% lidocaine injected in the supra/infra orbitary or mandibular foramens.…”

Section: Discussionmentioning

confidence: 99%

“…This study only included 6 patients and did not show a substantial improvement in quality of life 30 and 90 days after performing the block. Moreover, quality of life was a secondary objective of this study 10 . The main objective of the present study was thus to evaluate the effect of TNB on the quality of life 15 days after TNB in patients suffering from trigeminal neuralgia refractory to classically recommended clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

Trigeminal Nerve Blocks In Refractory Trigeminal Neuralgia: About 21 Cases Reported At The Limoges University Hospital

Jacques

Karoutsos

Marais

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction : Despite limited scientific evidence, trigeminal nerve blocks are alternative therapies for refractory trigeminal neuralgia (RTN). The duration of analgesia far exceeds the length of the conduction block. This study evaluated the quality of life 15 days after performing this block to treat RTN. Methods : This retrospective study included all patients who, after informed consent, received iterative trigeminal blocks to treat a RTN between 2014 and 2018 in a university hospital. Patients received 0.5% levobupivacaine in combination with clonidine and a corticosteroid (cortivazol or betamethasone according their availability). Data were obtained from patients medical data files and a telephone questionnaire for the SF-12 score. The main criteria of evaluation was the change in quality of life according SF-12 performed at day 15. Results : Twenty-one patients aged 62 years were included. All patients exhibited RTN after many different clinical treatments according ICHD-3 criteria. Seventy-one per cent of RTN occurred after trauma or surgery. Before receiving blocks, SF-12 physical (SF12-PS) and mental (SF-12 MS) scores reached respectively 35 and 29. A mean time of 4 years elapsed between the occurrence of RTN and nerve blockade. At day 15, SF-12 PS increased by a 3 point mean value and SF-12 MS by 5 points. Approximately half of the patients (55%) were considered as non-responders with a cut-off value of less than 10% variation of their initial SF-12 score. When excluding these patients, SF-12 PS and SF-12 MS were increased by 17 and 9 points respectively. The mean duration of blocks lasted 15 days and no severe adverse effects were observed. Patient satisfaction was correlated with increased SF-12 PS (r2 = 0.3 p = 0.01) and with the length of analgesia (r2 = 0.51 p = 0.001) but not to SF-12 MS variation (p = 0.12). Conclusion : Trigeminal nerve blocks are temporarily effective on pain that may increase the quality of life in responder patients. The reason why some patients are unresponsive to this treatment and why durations in efficacy are so variable remain unsolved. However, in responders, trigeminal nerve blocks seem simple, harmless, not excessively cumbersome and without severe adverse effects.

show abstract

“…A peripheral nerve block with different local anesthetics may be beneficial for some TN patients [ 125 , 126 ]. More recently, it has been suggested that the association of peripheral nerve block with systemic TN pharmacotherapy may result in better pain control with reduced side effects, due to the possibility of lowering anticonvulsant doses [ 127 - 129 ]. Finally, a few studies have proposed the application of local anesthetic trough medicated plasters, intranasal sprays and epidural catheters [ 130 , 131 ].…”

Section: Treatmentmentioning

confidence: 99%

Trigeminal Neuralgia: Basic and Clinical Aspects

Araya

Claudino

Piovesan

et al. 2020

Self Cite

101

View full text Add to dashboard Cite

The trigeminal nerve is the largest of all cranial nerves. It has three branches that provide the main sensory innervation of the anterior two-thirds of the head and face. Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, and stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. Pain attacks can occur spontaneously or can be triggered by non-noxious stimuli, such as talking, eating, washing the face, brushing teeth, shaving, a light touch or even a cool breeze. In addition to pain attacks, a proportion of the patients also experience persistent background pain, which along with autonomic signs and prolonged disease duration, represent predictors of worse treatment outcomes. It is now widely accepted that the presence of a neurovascular compression at the trigeminal root entry zone is an anatomic abnormality with a high correlation with classical TN. However, TN may be related to other etiologies, thus presenting different and/or additional features. Since the 1960s, the anticonvulsant carbamazepine is the drug of choice for TN treatment. Although anti-epileptic drugs are commonly used to treat neuropathic pain in general, the efficacy of carbamazepine has been largely limited to TN. Carbamazepine, however, is associated with dose-limiting side-effects, particularly with prolonged usage. Thus, a better understanding and new treatment options are urgently warranted for this rare, but excruciating disease.

show abstract

Combination of pharmacotherapy and lidocaine analgesic block of the peripheral trigeminal branches for trigeminal neuralgia: a pilot study

Cited by 17 publications

References 7 publications

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

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

Trigeminal Nerve Blocks In Refractory Trigeminal Neuralgia: About 21 Cases Reported At The Limoges University Hospital

Trigeminal Neuralgia: Basic and Clinical Aspects

Contact Info

Product

Resources

About