A trigeminal nerve block is used in the diagnosis and treatment of neuralgia. There are a couple different kinds of neuralgia that the block seems to be successful with. It may be successful with trigeminal neuralgia as well as post herpetic neuralgia. This is accomplished by providing the patient with anesthesia to one side of the face. It is used for diagnostic testing as well as treatment of recalcitrant herpes zoster.
The patient is first given something to relax them through an IV. Then the patient will be put on a table lying on their back. Then a very thin needle is placed into the side of the face and anesthetic is placed in the spot where the nerve is. After that, a steroid will be injected into the same location. This procedure usually lasts only about 30 minutes. It is usually done in a same day surgery center.
Patients are asked to take it easy for the rest of the day of the procedure. The next day should be sufficient time to return to your daily tasks. It is suggested that you don’t drive for the first 24 hours or do any extreme physical activity.
Many patients will see relief right after the procedure is completed. Sometimes pain will come back once the anesthesia wears off. After two or three days you may begin to see pain relief for a longer period of time. At this time the steroid will have taken effect and help with the relief. Pain relief will last for different lengths of time in different people. It can help some people for days and others for weeks. Many times people will need injections multiple times to get any consistent relief. Some patients see relief in two injections and others have to have ten of them before seeing any relief. Patients will tell you that the more injections that they have, the longer each of will last.
There are very few risks involved with this procedure. There may be some swelling, soreness and bruising near the injection site. Immediately after the procedure there may be some difficulty swallowing or numbness in your face. This will not last long and go away after a few hours. It is very uncommon to have serious complications such as bleeding, infection and nerve damage but the risk is there.
Patients who have tried all other treatments and didn’t have any success should consider trying the trigeminal nerve block.
Any patients who have coagulation problems or are on anticoagulant medication should not get the procedure. Patients who are on antiplatelet medication shouldn’t consider the procedure either. If the patient is pregnant, it is recommended to wait until after the birth to have the procedure done.
Cheridan MBBS, MD, DNB, Anusa. (2014). Trigeminal Nerve Block. Retrieved from http://emedicine.medscape.com/article/2040595-overview#a4
Tsui, B. C., & H., M. D. (2009). Ultrasound imaging to localize foramina for superficial trigeminal nerve block. Canadian Journal of Anesthesia, 56(9), 704-706. doi:http://dx.doi.org/10.1007/s12630-009-9129-3