What question did this study set out to answer?

The study aims to evaluate the effectiveness of trigeminal nerve blocks in alleviating pain for patients with medically intractable trigeminal neuropathy.

March 25, 2026Open Access

Trigeminal Nerve Blocks for Medically Intractable Painful Trigeminal Neuropathy

Key Points

The study aims to evaluate the effectiveness of trigeminal nerve blocks in alleviating pain for patients with medically intractable trigeminal neuropathy.
Retrospective chart review of 90 PTN patients from March 2023 to March 2025.
Administration of trigeminal nerve blocks using various local anesthetics and triamcinolone if appropriate.
Analysis of patient demographics, pain reduction outcomes, and prognostic factors.
81.1% of patients achieved at least 50% pain reduction after treatment.
Duration of relief varied, with 50% experiencing relief for 6 weeks or more.
Effective combinations included 2% lidocaine + triamcinolone, 2% lidocaine + 0.5% ropivacaine + triamcinolone, and 4% lidocaine + 0.75% bupivacaine + triamcinolone.

Abstract

Introduction: Painful trigeminal neuropathy (PTN) is a debilitating condition with persistent facial pain after a trigeminal nerve injury. It could be refractory to medication treatments and causes significant physical discomfort and psychological stress that significantly affects quality of life. This study aims to demonstrate the efficacy of trigeminal nerve blocks (TNB) for patients with PTN and to identify the parameters that affect treatment outcomes. Methods: In this retrospective chart review, we examined the medical records of 90 PTN patients who received trigeminal nerve blocks at Mass General Hospital (MGH) between March 2023 and March 2025. The trigeminal nerve blocks were performed using a variety of combinations of local anesthetics, from 2% lidocaine, 2% lidocaine plus 0.5% ropivacaine, to 4% lidocaine with 0.75% Bupivacaine. Triamcinolone was co-administered if no contraindication, including uncontrolled diabetes, hypertension, active infections, or psychological illness, existed. Results: The mean age was 50.6 years, and 71.1% of the participants were female. Seventy-three patients (81.1%) achieved ≥ 50% pain reduction. The duration of relief was: ≥ 6 weeks in 45 patients (50.0%), ≥ 8 weeks in 33 patients (36.7%), and ≥ 12 weeks in 21 patients (23.3%). Among the 33 patients with ≥ 8 weeks of relief, the effective regimens were: 2% lidocaine + triamcinolone (n=4, 12.1%), 2% lidocaine + 0.5% ropivacaine + triamcinolone (n=10, 30.3%), and 4% lidocaine + 0.75% bupivacaine + triamcinolone (n=13, 39.4%). The poor prognostic factors for treatment effects lasting shorter than 8 weeks include depression, involvement of the maxillary nerve (V2), and symptoms of facial numbness. Conclusion: The current study suggests that TNB with local anesthetics and steroids may be associated with better outcomes in patients with painful trigeminal neuropathy, based on this retrospective analysis. Keywords: facial pain, local anesthetics, triamcinolone, nerve injury, trigeminal neuropathy

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Cite This Study

Chen et al. (Sun,) studied this question.

synapsesocial.com/papers/69c37acab34aaaeb1a67cac0 https://doi.org/https://doi.org/10.2147/jpr.s574753

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