frequent procedures
 

TRIGEMINAL NERVE BLOCK

INDICATIONS: Trigeminal nerve block is usually used to treat trigeminal neuralgia or tic douloureux. The trigeminal nerve consists of three trunks, the ophthalmic branch, which lies above the level of the eyes into the forehead and temple, the maxillary branch, which lies below the level of the eye into the bridge of the nose, and the mandible branch, which lies along the mandible into the jaw. They meet in an area near the corneal sulcus in front of the preauricular region of the ipsilateral ear, to become the trigeminal nerve before ascending into the gasserian ganglion. Ten pathways that are present frequently affect the V2 and the V3 or may sometimes as in the case of postherpetic neuralgia or shingles may affect the V1 as well. The procedure involved in the treatment of trigeminal, tic douloureux, shingles, or atypical facial pain, which are the three indications for this procedure. This is done with the patient in a supine position with the position of the neck to one side, and then the palpation of the area in the preauricular region at the location of the corneal sulcus, through which a small needle is placed in and used to localize the trigeminal nerve with injection of local anesthesia and Depo-steroid occurring with approximately 5 cc or 6 cc of local anesthetic, and a small amount of Depo-Medrol, 40 mg, could be used. The Depo-steroid and local anesthetic achieve significant relief and the procedure is usually done serially to block the pain associated with this condition, and achieve resolution.

CONTRAINDICATIONS: Anticoagulant therapy is a contraindication and allergy also to the agent used, which is also a contraindication.

COMPLICATIONS: Nil of note, except for allergy and infection.

SEDATIVES: Sedatives are usually not indicated, though pre-medication can be provided for patients who are anxious before this procedure is done.

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