Trigeminal Nerve Block
Pain Management Nerve Blocks in Colorado
The trigeminal nerve block involves injecting medication that will relieve
facial pain. This block is a minimally invasive procedure that is done
in the doctor’s office. The trigeminal nerves supply the face and
help you bite, chew, and swallow.
What is the trigeminal nerve?
One of 12 cranial nerves that branch off the base of the brain, the trigeminal
nerve is responsible for providing sensation to the face. It is also involved
in several facial muscular functions. The nerve runs from the skull, and
branches into three divisions to supply the forehead, check, and lower jaw.
What conditions are treated with the trigeminal nerve block?
The trigeminal nerve block helps patients with:
- Trigeminal neuralgia
- Atypical facial pain
- Herpes zoster of the face
- Pain from a lesion or tumor
How do I prepare for the trigeminal nerve block?
You will first meet with the pain management specialist to discuss your
condition. The doctor takes a medical history and performs a physical
exam. Because bleeding is a risk, you must tell the doctor about all medications
and supplements you take. Certain blood-thinning agents are to be held
off for 5-7 days beforehand.
How is the trigeminal nerve block done?
When you arrive to the medical facility, a nurse goes over the procedure
risks and benefits and has you sign a consent form. After changing into
a procedure gown, the nurse places an IV catheter in your hand. Monitoring
devices are attached to your arm and finger, and an IV sedative is given.
The doctor cleans the side of your face with an antimicrobial agent, and
nubs the skin with lidocaine. The thin procedure needle is inserted and
positioned near the trigeminal nerve using x-ray guidance. An anesthetic
and corticosteroid agent are injected onto the nerve, the needle is removed,
and a bandage is applied.
What medications are used during the procedure?
While the block technique and medications vary, depending on the physician’s
training and choices, options include:
- Anesthetics – Lidocaine or bupivacaine.
- Corticosteroids – Triamcinolone, dexamethasone, or betamethasone.
- Neurolytic agents – Phenol or absolute alcohol.
- Antiseptics – Betadine.
What can I expect after the trigeminal nerve block?
Some patients have immediate relief after the trigeminal nerve block. As
the anesthetic wears off, you may experience pain again. However, the
corticosteroid starts to work in 48-72 hours, so analgesia returns. Because
a sedative is used, you may be groggy for a while, so a nurse monitors
you in the recovery area.
How long does the pain relief last?
After a trigeminal nerve block, pain relief duration varies from person
to person. Many patients are pain free for weeks, whereas others require
a series of injections for continued pain relief.
Does the trigeminal nerve block work?
The success of the trigeminal nerve block depends on the physician’s
expertise, the patient’s pain level, and the agent used. When radiofrequency
energy was used to destroy a portion of the nerve root, a study found
that the block had a 98% success rate. When glycerol was used to block
the nerve, a study found the rate to have a 90% efficacy rate.