Efficacy of Trigeminal Nerve Block Through Infrazygomatic Approach Compared to Combined Trigeminal Nerve Block and Stellate Ganglion Block in Trigeminal Neuralgia

Abstract Background Trigeminal Neuralgia is a disorder characterized by recurrent unilateral brief electric shock- like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve, and triggered by innocuous stimuli. This disorder could be primary without apparent cause or secondary to another diagnosed disorder. Aim of the study To assess and compare the effectiveness of ultrasound guided trigeminal nerve block through sphenopalatine ganglion block versus combined ultrasound guided sphenopalatine and stellate ganglia block in treatment of trigeminal neuralgia patients. Patients and Method This study was a two-arm interventional randomized controlled trial, included 30 patients, 15 in each arm (sphenopalatine ganglion block arm and combined sphenopalatine and stellate ganglion block), randomized by simple randomization, all patients were assessed initially by VAS score, brief pain inventory short form, penn scale for facial pain-revised and MRI brain done to exclude 2ry trigeminal neuralgia. The patients underwent nerve block ultrasound guided, then followed up after 2 weeks and 3 months by same scales. Results The two groups were matched as regards the demographic data and years lived with trigeminal neuralgia. The study revealed that SPG block and combined SPG and stellate ganglion block are statistically effective (p-value < 0.05) as regards reducing the trigeminal neuralgia. Conclusion Our study indicated that ultrasound guided trigeminal nerve block through SPG and combined trigeminal nerve block through SPG block and Stellate Ganglion block are effective treatment modalities for resistant Trigeminal Neuralgia, yet none is superior to the other.