Trigeminal nerve block under the ultrasound control in the pain medicine

Abstract

The leading clinical manifestation of trigeminal neuralgia is pain syndrome. Recently, an integrative biopsychosocial approach has been proposed in the study of pain. Trigeminal neuralgia is marked by a significant prevalence, often severe course, lack of sufficiently effective methods of treatment. The aim of the article was to introduce the technique of trigeminal nerve block under the ultrasound control. When the trigeminal nerve block is performed, the terminal sections of its three main branches are to be anesthetized. The maximum full and wide blockade can be achieved with the block of the Gasser's node, but performance of this procedure is complicated, requires a special qualification of a neurosurgeon and fluoroscopic control due to the complexity of the innervation of the head, the presence of mutually overlapping zones and commision. The most frequent indications for trigeminal nerve block are diagnostic, therapeutic and surgical blockades. It is recommened to consider the need for a combination of blocks, when anesthesia is planned. Double navigation with a neurostimulator is used for the accuracy of the needle positioning improvement. In this case, we expect a motor response from the masticatory muscle. Thus, the trigeminal nerve block under the ultrasound control can be used in the management of pain syndrome in trigeminal neuralgia.