COMBINED LIDOCAINE BLOCKADES WITH METHYLPREDNISOLONEIN THERAPY OF SEVERE TRIGEMINAL NEURALGIA: CLINICAL RESULTS

Objective. To estimate the efficacy of lidocaine blockades (LB) with methylprednisolone in patients with trigeminal neuralgia (TN) in both short- and long-term perspectives. The study analyzed the treatment of 44 patients with TN using peripheral nerve blocks: 31 women (70.45%) and 13 men (29.54%); mean age ± sd — 62.50±13.46 years; disease duration — 8.97 ± 9.6 years. The blocks were performed using a mixture of 4.0 ml of 2 % lidocaine with 1.00 ml of 40 mg/ml of methylprednisolone acetate («Depo-Medrol») administered paraneurally. Pain intensity was assessed using the Visual Analog Scale (VAS) at various time points: from 30 minutes to three years after the blockades. Pain intensity at admission ranged from 5.9 to 10 (8.66±1.06) cm on the VAS. Thirty minutes after the block, it decreased to 1.0—4.5 (2.75±0.67). Due to the return of pain, radical surgical interventions were performed in 36 patients. After 36 months, excellent and good results were achieved in 8 (18.18%) patients. Lidocaine blockades with methylprednisolone proved their high short-term efficacy with noticeable, however, decrease during first days with further restoration in terms from the first month to 3 years. The use of this approach is advisable as part of the comprehensive treatment of TN patients.