2025 Volume 53 Issue 2 Pages 83-89
Nerve blocks involve the insertion of a needle into a peripheral nerve or nerve trunk to block nerve conduction using local anesthetics, neurolytic agents, or radiofrequency thermocoagulation and can have either temporary or long-term effects. This review covers stellate ganglion block (SGB), trigeminal nerve block (TNB), and trigger point injections (TPI), all of which are nerve block therapies frequently performed at the Department of Pain Clinic at Kyushu Dental University Hospital.
SGB is used not only for painful conditions involving sympathetic nerve hyperactivity, but also for paralytic conditions such as trigeminal neuropathy and facial nerve palsy. SGB is also effective for treating neuroplastic pain. Importantly, SGB must be performed under ultrasound guidance to avoid complications.
TNB is often performed when pain relief is not achieved even after microvascular decompression (MVD) or gamma knife surgery. A block needle is inserted into the nerve trunk, and nerve conduction is blocked using a neurolytic agent and radiofrequency thermocoagulation. The nerve foramen is clearly identified under ultrasound guidance and fluoroscopy.
TPI is used to treatment myofascial pain and involves the injection of a local anesthetic into a trigger point to break vicious pain cycles and provide pain relief. If fascia involvement, in addition to myofascial pain, is recognized, myofascial release (MFR) is often used in combination with TPI. MFR releases the conglutination of fascia and the muscle body using an injection of saline or local anesthetics into stacking facia. Both procedures are performed under ultrasound guidance.
