UTILITY OF REAL-TIME ULTRASOUND-GUIDED INTERVENTION FOR TREATMENT OF TRIGEMINAL NEURALGIA - PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
Trigeminal neuralgia, infraorbital foramina, ultrasonography, ropivacaine, xylocaine
Abstract
Background: Trigeminal neuralgia is one of the most painful conditions occurring in the face. It causes sudden, severe, unilateral, sharp, stabbing, or burning pain along the distribution of the trigeminal nerve. Ultrasound imaging is helpful in localizing infraorbital foramina for giving superficial trigeminal nerve block.
Objectives: To evaluate the utility of real time ultrasound guided intervention for treatment of Trigeminal Neuralgia.
Methods: During the power Doppler examination, the Doppler frequency was set to 6.6MHz. 1% xylocaine, 0.25% ropivacaine) were injected using a 25-gauge 1.5-inch needle and for deeper nerveblocks, 3 to 5ml of the anaesthetic was injected using a 22- gauge 3-inch spinal needle after confirmation on aspiration.
Results: Statistically significant difference was observed when BNI pain scale was correlated with pre and post block timing (p<0.001). BNI pain score was correlated with block before and two weeks after and a statistically significant association was observed with a p value of < 0.001. Recurrent pain was experienced 30% of patients in our study. Neurolytic agent was needed by only 6.7% patients in our study. Increased utility of ultrasonography in identifying anatomical structure in relation to trigeminal neuralgia.
Conclusion: Real-time ultrasound guidance helps in identification of anatomical structures and visualizes an image of the spreading agent around the nerve. Real-time ultrasound guidance enables a high success rate for the block.
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Dr. Aasim Ahmad Ahangar
Department of Anaesthesiology and Critical Care, Government Medical College, Srinagar, Jammu and Kashmir, India
Dr. Arshi Taj
Department of Anaesthesiology and Critical Care, Government Medical College, Srinagar, Jammu and Kashmir, India
Dr. Najeeba Anjum
Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India