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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.

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