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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Intranasal self-administration of local anesthetic (ropivacaine) for sphenopalat...
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Vol. 66. Issue 8.
Pages 447-450 (October 2019)
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Vol. 66. Issue 8.
Pages 447-450 (October 2019)
Case report
DOI: 10.1016/j.redare.2019.02.006
Intranasal self-administration of local anesthetic (ropivacaine) for sphenopalatine ganglion block, for treatment of second trigeminal branch neuralgia secondary to maxillary sinus curettage: A case report
Autoadministración intranasal de anestésico local (ropivacaína) para bloqueo del ganglio esfenopalatino, para tratamiento de neuralgia de la segunda rama del trigémino secundaria a curetaje del seno maxilar: informe de un caso
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M.H. Lima
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mhelenamlima@hotmail.com

Corresponding author.
, M.J. Campos, A. Valentim, L. Paulo, S. Rego, E. Semedo
Departamento de Anestesiología, Centro Hospitalario y Universitario de Coimbra, Coimbra, Portugal
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Abstract

Trigeminal neuralgia (TN) is a severe and often underestimated facial pain that affects quality of life. Pharmacological treatment is insufficient for pain control in 30% of cases and, although intervention techniques may be effective, there is a possibility of relapse and associated complications. The second division of the trigeminal nerve (V2) runs through the sphenopalatine ganglion (SPG), which is anatomically accessible to blocking due to its superficial location in the nasal cavity. We report a clinical case of a patient with uncontrolled V2 TN that was put on ambulatory self-administered SPG block with nasal swabs soaked in 0.75% ropivacaine. In the follow-up visits, we confirmed that this adjuvant treatment provided a significant pain relief over 24h with a decrease in the number of exacerbations.

Keywords:
Trigeminal neuralgia
Sphenopalatine ganglion block
Intranasal ropivacaine
Adjuvant treatment
Nasal swab
Resumen

La neuralgia del trigémino es un dolor facial severo y a menudo subestimado, que afecta a la calidad de vida. El tratamiento farmacológico es insuficiente para controlar el dolor en el 30% de los casos y, aunque las técnicas de intervención pueden ser efectivas, existe posibilidad de recidiva y complicaciones asociadas. La segunda rama del nervio trigémino atraviesa el ganglio esfenopalatino, que es anatómicamente accesible al bloqueo, debido a su localización superficial en la cavidad nasal. Reportamos un caso clínico de un paciente con neuralgia del trigémino en la segunda rama incontrolada a quien se prescribió bloqueo del ganglio esfenopalatino ambulatorio autoadministrado con hisopo nasal con ropivacaína al 0,75%. Durante las visitas de seguimiento, confirmamos que este tratamiento adyuvante proporcionaba un alivio del dolor significativo durante 24horas, con descenso del número de exacerbaciones.

Palabras clave:
Neuralgia del trigémino
Bloqueo del ganglio esfenopalatino
Ropivacaína intranasal
Tratamiento adyuvante
Hisopo nasal

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