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Lidocaine local anesthesia is effective and safe to reduce pain in trigeminal neuralgia patients

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In people with trigeminal neuralgia, lidocaine local anesthesia can relieve pain, and also prevent arrhythmia and hypertension during Gasserian ganglion radiofrequency thermocoagulation.

A retrospective single-blind case-control study depicted that the lidocaine local anesthesia technique is safe, simple and can efficiently deliver good analgesic effects in people suffering from trigeminal neuralgia. Dingliang Zhao et al. aimed to evaluate the effectiveness and safety of lidocaine to treat trigeminal neuralgia.

Overall, 80 subjects diagnosed with trigeminal neuralgia and treated with radiofrequency thermocoagulation via oval foramen were recruited and randomly segregated into study and  placebo groups. After puncturing, a suitable concentration of lidocaine was administered, inside and outside of the oval foramen in the study group.

A similar dose of normal saline was administered by the same method in the placebo group. The visual analogue scale (VAS), heart rate (HR), and mean arterial pressure (MAP) were reported at various intervention temperatures. In the study arm, values of HR and MAP were reduced compared to the placebo arm, and the difference was statistically profound.

Moreover, a substantial difference in VAS, MAP, and HR at various treatment temperatures was witnessed in both groups. At the baseline along with each time point thereafter, remarkable differences in VAS and MAP were observed between the study group. The range of HR and MAP in the study group were found to be reduced when compared to the placebo recipients.

Hence, using lidocaine local anesthesia during radiofrequency treatment of trigeminal ganglion can effectively alleviate the reduction in HR due to trigeminocardiac reflex, and also mitigate the rise in blood pressure and HR elicited by pain during radiofrequency therapy. It exhibits a promising potential in improving the effectiveness and safety of Gasserian ganglion radiofrequency thermocoagulation.

Source:

BMC Anesthesiology

Article:

Cardiovascular response to Gasserian ganglion ablation on trigeminal neuralgia under local anesthesia: a retrospective single-blind case-control study

Authors:

Dingliang Zhao et al.

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