Abstract

PORRAL, R. et al. Effectiveness of the intragasserian blockade with glicerol versus depot metilprednisolone acetate in the trigeminal neuralgia: Effects in the short term. Rev. Soc. Esp. Dolor [online]. 2007, vol.14, n.8, pp.574-578. ISSN 1134-8046.

Objective. Determine quality and lasting of the analgesia in trigeminal neuralgia post intragasserian block with glycerol compared with metilprednisolone acétate deposit. Material and methods. In a prospective, compared, controlled, randomized, double-blind clinical trial, 20 patients with idiopatic trigeminal neuralgia, with no response to pharmacological treatment, were divided in two different groups. The procedure was made under fluoroscopy, with the Hartel technique, with periferic nerve stimulator and under type 2 monitoring. Group 1: intragasserian block with 40 mg of metilprednisolone acétate. Group 2: litic intragasserian block with 0.4 ceof 100% glycerol by affected branch. Pain relief was asses with the analogue visual scale (AVS 0= no pain, 10= worst pain possible) at 30, 60 and 180 minutes, an d at 1st, 2nd, 3rd and 4th weeks. The physicians that made the evaluation and patients were blind to the treatment. Results. No demografic differences was observed in both groups. We had the most frecueney of pain in V2 branch (45%), V3 (25%), V2 and V3 (15%), in the three branches 10% and in VI and V2 5%. In 70% of the patients the pain was in the right side of the face. The AVS previous to the procedure was equal in both groups (8 to 10). All the patients had a good response with no pain inmediately after the procedure but with progressive pain in the metilprednisolone acétate group since the first web, with pain scores similar to the ones previous to the procedure. In the glycerol group we observed a manteined pain relief, with a significant difference between the two groups (p=0.000015). Conclussion. In both groups we had more incidences of trigeminal neuralgia in women, in the V2 trigeminal branch, in the right side of the face, in ages between 6th and 7th decades. The time of pain relief with the litic block compare with the analgesic-desinflamatory had a significant difference. Considering the risk of the Gasser ganglion block, we do not recommend to do this with steroids deposit like definitive treatment of trigeminal neuralgia, because of the short time of pain relief.

Keywords : Trigeminal neuralgia; neurolysis; glycerol; Metilprednisolone.

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