Gasserian ganglion block for intractable cephalalgia caused by ethmoid sinus carcinoma: a case report

Abstract

A 60-year-old man developed right-sided cephalalgia and facial pain, caused by right-sided ethmoid sinus carcinoma, which had invaded the cranium and brain. Although the patient had received continuous intravenous 50 mg/day morphine infusion, the symptoms had not improved; subsequently, he was referred to our hospital. We changed the treatment regimen from morphine to continuous subcutaneous oxycodone and ketamine infusion; however, the therapeutic effect did not improve. Therefore, we performed a right Gasserian ganglion block (GGB) using absolute ethanol. After GGB, the opioid subcutaneous administration could be decreased and finally substituted with 1 mg/day transdermal fentanyl. Although for a short period of time, the patient could be discharged from the hospital. GGB was effective not only against facial pain, but also against cephalalgia caused by cancer-invaded dura mater.