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

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 (TN) 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 TN, who underwent peripheric trigeminal nerve injection with lidocaine and triamcinolone between 2011 and 2018, were included in the study. Pain severity, pain frequency, changes in carbamazepine (CBZ) 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 months (p=0.000).There was a statistically significant difference between CBZ equivalent doses at baseline, and 3 and 6 months after the procedure (p=0.002 and 0.005, respectively).Two complications were evaluated, one patient had prolonged painless paresthesia related to the procedure area lasting about 1 week and two 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.