International Journal of Medical Sciences
Official Impact Factor

27 February 2017

ISSN 1449-1907 News feeds of published articles

Manuscript Status/Login | Contact

Journal of Genomics now in PubMed/PubMed Central. Submit manuscript...

Journal of Biomedicinenew

Theranostics

Journal of Cancer

Oncomedicine

International Journal of Biological Sciences

Journal of Genomics

Journal of Bone and Joint Infection (JBJI)

Nanotheranostics

PubMed Central Indexed in Journal Impact Factor

Int J Med Sci 2017; 14(1):29-36. doi:10.7150/ijms.16964

Research Paper

Trigeminal nerve block with alcohol for medically intractable classic trigeminal neuralgia: long-term clinical effectiveness on pain

Kyung Ream Han1✉, Yun Jeong Chae2, Jung Dong Lee2, Chan Kim3

1. Kichan Pain Clinic, Suwon, Korea;
2. Anesthesiology and Pain medicine, Ajou University Hospital, Suwon Korea;
3. Kimchan Hospital, Suwon, Korea.

Abstract

Background: Trigeminal nerve block (Tnb) with alcohol for trigeminal neuralgia (TN) may not be used widely as a percutaneous procedure for medically intractable TN in recent clinical work, because it has been considered having a limited duration of pain relief, a decrease in success rate and increase in complications on repeated blocks.

Objectives: To evaluate the clinical outcome of the Tnb with alcohol in the treatment of medically intractable TN.

Methods: Six hundred thirty-two patients were diagnosed with TN between March 2000 and February 2010. Four hundred sixty-five out of 632 underwent Tnb with alcohol under a fluoroscope. Pain relief duration were analyzed and compared in the individual branch blocks. Outcomes were compared between patients with and without a previous Tnb with alcohol.

Results: Tnb with alcohol were performed in a total 710 (1st-465, 2nd-155, 3rd-55, 4th-23, 5th-8, 6th-4) cases for a series of consecutive 465 patients during the study period. Forty hundred sixty two out of the 465 patients experienced immediate complete pain relief (99%) at the first Tnb. Of the 465 patients, 218 patients (46.9%) did not require any further treatment after the first Tnb with alcohol during an entire study period. One hundred fifty nine (34.2 %) out of the 465 patients experienced recurring pain after the first block, among whom 155 patients received subsequent blocks, and the remaining 4 patients decided to take medication. According to the Kaplan-Meier analysis, the probabilities of remaining pain relief for 1, 2, 3, and 5 years after the procedures were 86.2%, 65.5%, 52.5%, and 33.4%, respectively. There was no significant difference in the probability of pain relief duration between patients with and without previous Tnb with alcohol. Median (95% CI) pain relief durations of the first and repeated blocks were 39 (36-51) and 37 (28-54) months, respectively. There was no significant difference in occurrence of complications between patients with and without previous Tnb with alcohol (p <0.076). All the complications recovered spontaneously within 6 months. There was no mortality related to the procedure.

Conclusions: Tnb with alcohol for the pain management of TN can provide considerably long lasting pain relief. Repeated Tnb with alcohol has pain relief duration as long as the first block, and seems to produce less complication as well. Tnb with alcohol is a valuable treatment modality of TN as a percutaneous procedure.

Keywords: trigeminal neuralgia, trigeminal nerve block, alcohol, neurolysis.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Han KR, Chae YJ, Lee JD, Kim C. Trigeminal nerve block with alcohol for medically intractable classic trigeminal neuralgia: long-term clinical effectiveness on pain. Int J Med Sci 2017; 14(1):29-36. doi:10.7150/ijms.16964. Available from http://www.medsci.org/v14p0029.htm