Multi-Jurisdictional Contractor Advisory Committee (CAC) Peripheral Nerve Blocks - Key Questions and References

Chronic Knee Osteoarthritis

Genicular Nerve Block

  1. What is the evidence and/or society guidelines concerning the provision of nonsurgical (conservative) care prior to proceeding with therapeutic genicular nerve block, or a related procedure i.e., radiofrequency ablation or cryoneurolysis?
  2. Is there evidence to support a minimum trial (time frame and number of therapies) of conservative therapy prior to proceeding to a genicular nerve block?
  3. What is the evidence and/or society guidelines concerning absolute and relative contraindications to receiving a genicular nerve block? [McCormick (2018)]
  4. What is the evidence (direct and indirect) regarding the efficacy and safety of different genicular block techniques e.g., anatomical landmark- vs. fluoroscopic- vs. ultrasound-guided procedures?
  5. What is the evidence and/or society guidelines concerning factors likely to influence genicular nerve block outcomes? [number of needles/nerves blocked, size of needles, KL grade, etc.]
  6. What is the evidence and/or society guidelines concerning the efficacy of genicular nerve blocks compared to placebo/sham, procedures?
  7. What is the evidence and/or society guidelines concerning the frequency of therapeutic genicular nerve blocks?
  8. What is the evidence and/or society guidelines concerning the provision of diagnostic genicular nerve blocks prior to radiofrequency ablation (RFA) procedures? [McCormick (2017), Jamison (2018)]

Radiofrequency Ablation

  1. What is the evidence and/or society guidelines concerning the efficacy of genicular RFA compared to genicular nerve blocks, placebo/sham, or other active interventions?
  2. What is the evidence and/or society guidelines concerning the comparative safety and efficacy of different genicular RFA techniques e.g., conventional RFA vs. cooled RFA; anatomical landmark- vs. fluoroscopic- vs. ultrasound-guided procedures?) [ Mittal (2021), Kapural (2022)]
  3. What is the evidence and/or society guidelines concerning the frequency genicular RFA?

References

  1. Jamison DE, Cohen SP. Radiofrequency techniques to treat chronic knee pain: a comprehensive review of anatomy, effectiveness, treatment parameters, and patient selection. J Pain Res. 2018;11:1879-1888. Published 2018 Sep 18. doi:10.2147/JPR.S144633. Full Text
  2. McCormick ZL, Reddy R, Korn M, et al. A Prospective Randomized Trial of Prognostic Genicular Nerve Blocks to Determine the Predictive Value for the Outcome of Cooled Radiofrequency Ablation for Chronic Knee Pain Due to Osteoarthritis. Pain Med. 2018;19(8):1628-1638. doi:10.1093/pm/pnx286. Full Text
  3. Mittal N, Catapano M, Peng PWH. Knee Ablation Approaches. Phys Med Rehabil Clin N Am. 2021;32(4):779-790. doi:10.1016/j.pmr.2021.05.012. Full Text
  4. Kapural L, Minerali A, Sanders M, Matea M, Dua S. Cooled Radiofrequency Ablation Provides Prolonged Pain Relief Compared to Traditional Radiofrequency Ablation: A Real-World, Large Retrospective Clinical Comparison from a Single Practice. J Pain Res. 2022;15:2577-2586. Published 2022 Aug 31. doi:10.2147/JPR.S373877. Full Text

PNB Pnb of the Trunk

Intercostal Nerve Block in Thoracic Surgeries

  1. Is there sufficient high-quality evidence to support the use of Intercostal Nerve Blocks for postoperative analgesia in thoracic surgeries, such as Video-Assisted Thoracoscopic Surgery and thoracotomy, compared to alternative regional anesthesia techniques like thoracic epidural analgesia, paravertebral block, and erector spinae plane block?

Context from Literature:

  • Xu et al. (2024) and Shen et al. (2024) found Intercostal Nerve Block to be less effective than thoracic paravertebral block and paravertebral block/erector spinae block in reducing postoperative pain in Video-Assisted Thoracoscopic Surgery.
  • Wang et al. (2023) and Gams et al. (2023) reported that erector spinae block provided better analgesia and reduced opioid consumption more effectively than Intercostal Nerve Block.
  • Vilvanathan et al. (2020) observed that thoracic epidural analgesia offered superior pain control over Intercostal Nerve Block in thoracotomy patients.
  • Sung et al. (2024) found no significant difference between Intercostal Nerve Block and erector spinae block in pain scores, but Intercostal Nerve Block did not demonstrate superiority.

Considerations for Discussion:

  • Evaluate the quality and sample sizes of the studies comparing Intercostal Nerve Block to other regional blocks.
  • Discuss the consistency of findings across different studies and surgical procedures.
  • Assess whether Intercostal Nerve Block should be preferred, equivalent, or secondary to other regional anesthesia techniques based on current evidence.

Effectiveness of Intercostal Nerve Block on Opioid Consumption and Patient Outcomes

  1. Does the current literature support the effectiveness of Intercostal Nerve Block in reducing postoperative opioid consumption and improving patient-centered outcomes such as quality of recovery and patient satisfaction in various surgical procedures, including non-thoracic surgeries?

Context from Literature:

  • Ma et al. (2022) and Luo et al. (2017) demonstrated that Intercostal Nerve Block significantly reduced opioid consumption and improved quality of life in pediatric patients undergoing the Nuss procedure.
  • Altiparmak et al. (2023) reported higher quality of recovery scores and lower opioid requirements with Intercostal Nerve Block in modified radical mastectomy patients.
  • Deng et al. (2021) found that Intercostal Nerve Block led to lower postoperative opioid use and fewer side effects in thoracic surgery.
  • Mehmet Selim et al. (2024) and Gangadhar et al. (2024) showed mixed results in laparoscopic cholecystectomy, with some benefits observed when Intercostal Nerve Block was combined with other blocks.

Considerations for Discussion:

  • Analyze the impact of Intercostal Nerve Block on opioid-sparing effects across different surgical populations.
  • Discuss the relevance of improved patient satisfaction and quality of recovery in evaluating the efficacy of Intercostal Nerve Block.
  • Consider the applicability of these findings to broader patient populations and practice settings.

Limitations and Risks of Intercostal Nerve Block for Postoperative Analgesia

  1. What are the limitations and potential risks associated with the use of Intercostal Nerve Block for postoperative analgesia, and does the evidence adequately address these concerns to support its widespread adoption in clinical practice?

Context from Literature:

  1. Several studies (Xu et al., 2024; Shen et al., 2024; Ueda et al., 2019) highlighted limitations such as small sample sizes, lack of blinding, and short follow-up periods.
  2. The risk of incomplete analgesia and the need for rescue analgesia were noted in some trials (Vilvanathan et al., 2020; Chen et al., 2023).
  3. Potential complications, although infrequent, were not extensively studied or reported in the literature provided.
  4. Heterogeneity in techniques, dosages, and patient populations raises questions about the generalizability of the results.

Considerations for Discussion:

  • Evaluate the methodological quality and risk of bias in the existing studies on Intercostal Nerve Block.
  • Discuss the potential risks or adverse effects associated with Intercostal Nerve Block compared to other analgesic techniques.
  • Consider whether the current evidence sufficiently mitigates concerns to recommend Intercostal Nerve Block as a standard practice.

Ganglion Impar Block for Coccydynia

  1. Is there sufficient high-quality evidence to support Ganglion Impar Block as an effective treatment for chronic coccydynia in patients unresponsive to conservative management?

Context:

Multiple studies report significant pain reduction following Ganglion Impar Block in patients who did not benefit from conservative treatments. However, many of these studies have limitations such as small sample sizes, lack of control groups, short follow-up durations, and potential biases.

Considerations:

  • Does the current literature provide robust and generalizable evidence for the efficacy of Ganglion Impar Block?
  • How do methodological weaknesses in the studies impact the confidence in Ganglion Impar Block as a standard treatment option?
  • Are the observed benefits clinically significant and sustainable over the long term?

Pudendal Nerve Block for Chronic Pain

  1. Is there sufficient evidence to support the routine use of pudendal nerve blocks for reducing postoperative pain and analgesic requirements in adult patients undergoing perineal surgeries such as hemorrhoidectomy and gynecological procedures compared to standard anesthesia techniques?

Context from Literature:

  • Supporting studies include work by Li et al. (2021), Xia et al. (2023), and Dengler et al. (2021), showing significant pain reduction in patients receiving pudendal nerve blocks.
  • Conflicting evidence exists, such as Giugale et al. (2021), who found no significant difference in pain scores or opioid consumption with pudendal nerve blocks in vaginal prolapse repairs.

Considerations for Discussion:

  • Discuss the balance of evidence, particularly in surgical populations with mixed outcomes. Should pudendal nerve blocks be considered as a standard practice in these contexts?

Cryoneurolysis and Radiofrequency Ablation for Chronic Pain

  1. Is there sufficient evidence supporting cryoneurolysis over radiofrequency ablation for the treatment of chronic pain conditions, such as facet joint pain?

Context from Literature:

  • Several studies (e.g., Truong et al., 2024) suggest no significant long-term benefit of cryoneurolysis compared to placebo in managing chronic low back pain. Meanwhile, radiofrequency ablation continues to show more reliable outcomes in long-term pain relief (Manchikanti et al., 2024).

Considerations for Discussion:

  • Given the mixed evidence, should cryoneurolysis be considered an alternative to radiofrequency ablation, and what are the indications for its use?

Nerve Entrapments and Peripheral Nerve Blocks

  1. In patients with nerve entrapment syndromes, such as anterior cutaneous nerve entrapment or lateral femoral cutaneous nerve entrapment (meralgia paresthetica), does the literature support peripheral nerve blocks as a superior treatment compared to conservative therapies or surgical options?

Context from Literature:

  • Studies by Mol et al. (2018) and Kiliç et al. (2020) show significant pain reduction following nerve blocks in patients with various nerve entrapments, such as abdominal wall or groin pain.

Considerations for Discussion:

  • Evaluate the applicability of peripheral nerve blocks as a long-term solution for nerve entrapments and the implications for treatment protocols.

References

Intercostal Blocks
  1. Altiparmak B, Korkmaz Toker M, Uysal AI, Dere Ö, Ugur B. Evaluation of ultrasound-guided rhomboid intercostal nerve block for postoperative analgesia in breast cancer surgery: a prospective, randomized controlled trial. Reg Anesth Pain Med. 2020;45(4):277-282. [Closed Access]
  2. Deng W, Hou XM, Zhou XY, Zhou QH. Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial. BMC Pulm Med. 2021;21(1):68. Full Text
  3. Gams P, Bitenc M, Danojevic N, Jensterle T, Sadikov A, Groznik V, Sostaric M. Erector spinae plane block versus intercostal nerve block for postoperative analgesia in lung cancer surgery. Radiol Oncol. 2023;57(3):364-370. Full Text
  4. Luo M, Liu X, Ning Q, Shin SW, Kim KH. Comparison of ultrasonography-guided bilateral intercostal nerve blocks and conventional patient-controlled intravenous analgesia for pain control after the Nuss procedure in children: A prospective randomized study. Clin J Pain. 2017;33(7):604-610. Full Text
  5. Wang T, Wang X, Yu Z, Li M. Programmed Intermittent Bolus for Erector Spinae Plane Block Versus Intercostal Nerve Block with Patient-controlled Intravenous Analgesia in Video-assisted Thoracoscopic Surgery: A Randomized Controlled Noninferiority Trial. Clin J Pain. 2024;40(2):99-104. Full Text
  6. Li, Yana; Wei, Luyaoa; Du, Jian-Huia; He, Jin-Xianb; Xu, Xiaa,*; Hu, Li-Honga,*. Comparison of thoracoscopic-guided intercostal nerve block and ultrasound-guided intercostal nerve block in postoperative analgesia of uniportal video-assisted lobectomy: a pilot randomized controlled trial. International Journal of Surgery ():10.1097/JS9.0000000000002165, December 20, 2024. | DOI: 10.1097/JS9.0000000000002165. Full Text
Pudendal blocks
  1. Dengler KL, Craig ER, DiCarlo-Meacham AM, Welch EK, Brooks DI, Vaccaro CM, Gruber DD. Preoperative pudendal block with liposomal and plain bupivacaine reduces pain associated with posterior colporrhaphy: A double-blinded, randomized controlled trial. Am J Obstet Gynecol. 2021;225(5):556.e1-556.e10. [Closed Access]
  2. Xia S, Luo L, Wu W, Lu K, Jiang T, Li Y. The role of pudendal nerve block in hemorrhoid surgery: a systematic review and meta-analysis of double-blind randomized controlled trials. Front Med (Lausanne). 2023 Dec 13;10:1283512. doi: 10.3389/fmed.2023.1283512. PMID: 38152300; PMCID: PMC10751314. Full Text
  3. Xia H, Chen L, Feng X, et al. Ultrasound-guided pudendal nerve blocks for hemorrhoid surgery: A systematic review and meta-analysis of double-blind RCTs. Reg Anesth Pain Med. 2023;48(2):112-119. Full Text

Head, Neck, and Upper Extremity

Carpal Tunnel Syndrome

  1. Is there evidence to support the use either block and/or steroid for acute pain in patients with carpal tunnel syndrome?
  2. Is there evidence to support peripheral nerve blocks for treatment of chronic pain in patients with carpal tunnel syndrome?
  3. Is there evidence to support number frequency of peripheral nerve blocks for successful treatment of carpal tunnel syndrome?

References

  1. Zhang S, Wang F, Ke S, et al. The Effectiveness of Ultrasound-Guided Steroid Injection Combined with Miniscalpel-Needle Release in the Treatment of Carpal Tunnel Syndrome vs. Steroid Injection Alone: A Randomized Controlled Study. Biomed Res Int. 2019;2019:9498656. Full Text
  2. Dong C, Zhu Y, Zhou J, Dong L, Hu L. Comparison of Distal and Proximal Local Steroid Injection for Carpal Tunnel Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Pain Ther. 2022;11(4):1389-1402. Full Text
  3. Wang JC, Liao KK, Lin KP, et al. Efficacy of Combined Ultrasound-Guided Steroid Injection and Splinting in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017;98(5):947-956. [Closed Access]
  4. Salman Roghani R, Holisaz MT, Tarkashvand M, et al. Different doses of steroid injection in elderly patients with carpal tunnel syndrome: a triple-blind, randomized, controlled trial. Clin Interv Aging. 2018;13:117-124. Full Text
  5. Mathew MM, Gaur R, Gonnade N, Asthana SS, Ghuleliya R. Efficacy of Ultrasound-Guided Particulate Versus Nonparticulate Steroid Injection in Carpal Tunnel Syndrome: An Open-Label Randomized Control Trial. Cureus. 2022;14(1):e21591. Full Text
  6. Karaahmet OZ, Gurcay E, Kara M, Serce A, Kirac Unal Z, Cakci A. Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome. Turk J Med Sci. 2017;47(6):1785-1790. Full Text
  7. Hofer M, Ranstam J, Atroshi I. Extended Follow-up of Local Steroid Injection for Carpal Tunnel Syndrome: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(10):e2130753. Full Text
  8. Awan AS, Khan A, Afridi SA, et al. Early Response of Local Steroid Injection Versus Mini Incision Technique in Treatment of Carpal Tunnel Syndrome. J Ayub Med Coll Abbottabad. 2015;27(1):192-196. Full Text

Occipital Neuralgia Nerve Block

  1. Is there evidence to support blocks as a mechanism to diagnose occipital neuralgia?
  2. Is there evidence to support of block application to effectively relieve pain as compared to standard of care in patients with occipital neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain in patients with occipital neuralgia?

References

  1. Evans AG, Joseph KS, Samouil MM, et al. Nerve blocks for occipital headaches: A systematic review and meta-analysis. J Anaesthesiol Clin Pharmacol. 2023;39(2):170-180. Full Text
  2. Kissoon NR, O'Brien TG, Bendel MA, et al. Comparative Effectiveness of Landmark-guided Greater Occipital Nerve (GON) Block at the Superior Nuchal Line Versus Ultrasound-guided GON Block at the Level of C2: A Randomized Clinical Trial (RCT). Clin J Pain. 2022;38(4):271-278. [Closed Access]
  3. Gul HL, Ozon AO, Karadas O, Koc G, Inan LE. The efficacy of greater occipital nerve blockade in chronic migraine: A placebo-controlled study. Acta Neurol Scand. 2017;136(2):138-144. Full Text
  4. Lambru G, Stubberud A, Rantell K, Lagrata S, Tronvik E, Matharu MS. Medical treatment of SUNCT and SUNA: a prospective open-label study including single-arm meta-analysis. J Neurol Neurosurg Psychiatry. 2021;92(3):233-241. Full Text

Stellate Ganglion

  1. Is there evidence to support stellate ganglion blocks for hot flashes as compared to standard of care therapies? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  2. Is there evidence to support stellate ganglion blocks for spasticity as compared to standard of care? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  3. Is there evidence to support stellate ganglion blocks for PTSD as compared to standard of care therapies? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  4. Is there evidence to support stellate ganglion blocks in adults with complex regional pain syndrome as compared to standard of care? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  5. Is there evidence to support stellate ganglion block in patients with Bell’s Palsy? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  6. Is there evidence to support stellate ganglion blocks for postherpetic neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  7. Is there evidence to support stellate ganglion blocks in relieving acute postoperative pain? If so, is there evidence to support number and frequency of block application to effectively relieve pain?

References

  1. Yoo Y, Lee CS, Kim YC, Moon JY, Finlayson RJ. A Randomized Comparison between 4, 6 and 8 mL of Local Anesthetic for Ultrasound-Guided Stellate Ganglion Block. J Clin Med. 2019;8(9). Full Text
  2. Yuan Z, Luo J, Cheng QF, Zhang Q. Clinical efficacy of ultrasound-guided stellate ganglion block combined with extracorporeal shock wave therapy on limb spasticity in patients with ischemic stroke. BMC Neurol. 2023;23(1):349. Full Text
  3. Wang C, Yuan F, Cai L, Lu H, Chen G, Zhou J. Ultrasound-Guided Stellate Ganglion Block Combined with Extracorporeal Shock Wave Therapy on Postherpetic Neuralgia. J Healthc Eng. 2022;2022:9808994. Full Text
  4. Walega DR, Rubin LH, Banuvar S, Shulman LP, Maki PM. Effects of stellate ganglion block on vasomotor symptoms: findings from a randomized controlled clinical trial in postmenopausal women. Menopause. 2014;21(8):807-814. Full Text
  5. Shan HH, Chen HF, Ni Y, Yang JX, Zhou XL. Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound. Front Surg. 2021;8:797793. Full Text
  6. Rae Olmsted KL, Bartoszek M, Mulvaney S, et al. Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(2):130-138. Full Text
  7. Othman AH, Zaky AH. Management of hot flushes in breast cancer survivors: comparison between stellate ganglion block and pregabalin. Pain Med. 2014;15(3):410-417. Full Text
  8. Naskar S, Bhoi D, Garg H, Dehran M, Trikha A, Ansari MT. A comparison of analgesic efficacy and safety of clonidine and methylprednisolone as additives to 0.25% ropivacaine in stellate ganglion block for the treatment of complex regional pain syndrome: a prospective randomised single blind study. Korean J Pain. 2023;36(2):216-229. Full Text
  9. Liu GD, He CJ. Stellate ganglion block promotes recovery of Bell's palsy in patients with diabetes mellitus. Acta Otolaryngol. 2014;134(6):652-655. [Closed Access]
  10. Li Y, Chang J, Shi G, et al. Effects of stellate ganglion block on perimenopausal hot flashes: a randomized controlled trial. Front Endocrinol (Lausanne). 2023;14:1293358. Full Text
  11. Kuroda H, Katagiri N, Kagawa K, et al. Comparison of Lidocaine and Mepivacaine for Variation in Regional Tissue Oxygenation in Stellate Ganglion Block: A Randomized, Double-Blind, Crossover Trial. Cureus. 2023;15(10):e47938. Full Text
  12. Kawabata K, Sago T, Oowatari T, Shiiba S. Prolonged blockade of the cervical sympathetic nerve by stellate ganglion block accelerates therapeutic efficacy in trigeminal neuropathy. J Oral Sci. 2022;64(1):6-10. Full Text
  13. Hanling SR, Hickey A, Lesnik I, et al. Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial. Reg Anesth Pain Med. 2016;41(4):494-500. Full Text
  14. Tian Y, Hu Y, Hu T, et al. Stellate Ganglion Block Therapy for Complex Regional Pain Syndrome: A Systematic Review and Meta-Analysis. Pain Physician. 2024;27(4):175-184. Full Text
  15. Wen B, Wang Y, Zhang C, Fu Z. Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis. BMC Surg. 2020;20(1):284. Full Text
  16. Zhao Y, Xiao X. Efficacy of ultrasound-guided stellate ganglion block in relieving acute postoperative pain: a systematic review and meta-analysis. J Int Med Res. 2024;52(5):3000605241252237. Full Text

Trigeminal Neuralgia

  1. Is there evidence to support peripheral nerve blocks for short term use in patients with trigeminal neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  2. Is there evidence to support peripheral nerve blocks for diagnostic blocks in patients with trigeminal neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  3. Is there evidence to support peripheral nerve blocks for refractory trigeminal neuralgia cases? If so, is there evidence to support number and frequency of block application to effectively relieve pain?

References

  1. Niki Y, Kanai A, Hoshi K, Okamoto H. Immediate analgesic effect of 8% lidocaine applied to the oral mucosa in patients with trigeminal neuralgia. Pain Med. 2014;15(5):826-831. Full Text
  2. Elsheikh NA, Amr YM. Calcitonin as an Additive to Local Anesthetic and Steroid Injection Using a Modified Coronoid Approach in Trigeminal Neuralgia. Pain Physician. 2016;19(7):457-464. Full Text
  3. Moore D, Chong MS, Shetty A, Zakrzewska JM. A systematic review of rescue analgesic strategies in acute exacerbations of primary trigeminal neuralgia. Br J Anaesth. 2019;123(2):e385-e396. Full Text
  4. Lambru G, Stubberud A, Rantell K, Lagrata S, Tronvik E, Matharu MS. Medical treatment of SUNCT and SUNA: a prospective open-label study including single-arm meta-analysis. J Neurol Neurosurg Psychiatry. 2021;92(3):233-241. Full Text
  5. Ho KWD, Przkora R, Kumar S. Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review. J Headache Pain. 2017;18(1):118. Full Text
  6. Di Stani F, Ojango C, Dugoni D, et al. Combination of pharmacotherapy and lidocaine analgesic block of the peripheral trigeminal branches for trigeminal neuralgia: a pilot study. Arq Neuropsiquiatr. 2015;73(8):660-664. Full Text

Radiofrequency, Trigeminal Neuralgia

  1. Is there evidence that supports radiofrequency ablation decreases pain in patients with trigeminal neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  2. Is there evidence that demonstrates radiofrequency ablation may aid in prevention of surgery in the patient with trigeminal neuralgia? If so, is there evidence to support number and frequency of block application to effectively relieve pain?
  3. Is there evidence that demonstrates the duration of effect of radiofrequency ablation in patients with trigeminal neuralgia?

References

  1. Zheng S, Li X, Yang L, et al. Masticatory Dysfunction After Computed Tomography-Guided Plasma Ablation vs. Radiofrequency Ablation on Gasserian Ganglion for Idiopathic Trigeminal Neuralgia: A Randomized Controlled Trial. Pain Med. 2021;22(3):606-615. Full Text
  2. Zhao C, Shrestha N, Liu H, et al. The PATCH trial: efficacy and safety of 5% lidocaine-medicated plaster for the treatment of patients with trigeminal neuralgia: a study protocol for a multicentric, double-blind, enriched enrolment randomized withdrawal, vehicle-controlled study. BMJ Open. 2021;11(8):e045493. Full Text
  3. Yildiz G, Akkaya OT. A Comparison Between the Efficacy of Trigeminal Ganglion Radiofrequency Thermocoagulation and Ultrasound-Guided Maxillary-Mandibular Nerve Pulsed Radiofrequency in the Treatment of Trigeminal Neuralgia: A Randomized Clinical Trial. Cureus. 2024;16(6):e61565. Full Text
  4. Texakalidis P, Xenos D, Karras CL, Rosenow JM. Percutaneous Surgical Approaches in Multiple Sclerosis-Related Trigeminal Neuralgia: A Systematic Review and Meta-analysis. World Neurosurg. 2021;146:342-350 e341. [Closed Access]
  5. Moore D, Chong MS, Shetty A, Zakrzewska JM. A systematic review of rescue analgesic strategies in acute exacerbations of primary trigeminal neuralgia. Br J Anapests. 2019;123(2):e385-e396. Full Text
  6. Ho KWD, Przkora R, Kumar S. Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review. J Headache Pain. 2017;18(1):11. Full Text
Last Updated Jan 13 , 2025