EFFICACY OF ULTRASOUND GUIDED PERIPHERAL NERVE BLOCKS IN TRIGEMINAL NEURALGIA PATIENTS RECEIVING COMBINATION DRUG THERAPY
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Keywords
Trigeminal neuralgia, ultrasound-guided nerve block, maxillofacial pain, neurovascular compression, pharmacotherapy, multimodal management, nerve block, pain relief, facial neuralgia, minimally invasive therapy
Abstract
Neuralgia involves pain along a damaged nerve, often resulting from injury or underlying pathology. Maxillofacial pain—originating from structures such as meninges, cornea, pulp, mucosa, and TMJ—comprises various neurological disorders that significantly impact patients' quality of life. Trigeminal neuralgia (TN), characterized by sudden, severe, shock-like facial pain, is among the most intense and common facial pain disorders. Diagnosis is primarily clinical, with neurovascular compression as a key etiology. Current treatments include pharmacotherapy, nerve blocks, and surgical procedures, but limitations such as adverse effects and procedural risks necessitate alternative approaches. Ultrasound-guided nerve blocks, combined with multi-drug regimens, present a minimally invasive option with potential benefits.
Objective: To evaluate the efficacy of ultrasound-guided peripheral nerve blocks combined with pharmacological therapy in patients with TN, focusing on pain reduction measured by the Numeric Rating Scale (NRS), safety, and patient satisfaction.
Methods: This prospective observational study included 33 patients with clinically diagnosed TN. All received a standardized three-drug regimen (carbamazepine, amitriptyline, baclofen) for 15 days, followed by ultrasound-guided nerve blocks targeting trigeminal divisions. Pain intensity was assessed at baseline, 15, and 30 days. Data analysis involved comparison of NRS scores and satisfaction levels.
Results: Significant reductions in NRS scores were observed in both groups, with a greater decrease in the nerve block group (from 7.75 to 1.25) versus the drug-only group (from 6.24 to 1.76) at 30 days (p<0.001). The percent change in pain was also significantly higher in the nerve block group. No major adverse effects were reported, and patient satisfaction was comparable.
Conclusion: Ultrasound-guided trigeminal nerve blocks, combined with multi-drug therapy, are effective and safe in managing TN pain. This multimodal strategy offers an advantageous alternative or adjunct to conventional treatments, potentially improving patient outcomes and reducing reliance on systemic medications.
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Dr. Narendra Singh Yadav
Assistant Professor, BRD Medical College, Gorakhpur, UP, India
Dr. Avinash Kumar
Assistant Professor, BRD Medical College, Gorakhpur, UP, India
Dr. Veerendra Singh Yadav
Associate Professor, Rani Durgavati Medical College, Banda, UP, India
Dr. Jitendra Singh Yadav
Prasad Medical College Lucknow , UP, India