Ultrasound-guided high concentration tetracaine peripheral nerve block: Effective and safe relief while awaiting more permanent intervention for tic douloureux

摘要

In this issue of the Scandinavian Journal of Pain Kenichi Takechi and co-workers report on another useful pain nerve block using ultrasound (US) guidance to deposit a high concentration tetracaine (40 mg/ml) dissolved in bupivacaine (5 mg/ml) around the infraorbital nerve in patients with tic douloureux of the second branch of the trigeminal nerve (V2) [1 ]. They report pain relief lasting up to at least 6 months. They did not observe any of the adverse effects of other neurolytic solutions: after phenol, glycerol, or ethanol up to almost 1/3 of cases experience damage to surrounding tissues, neuritis, de-afferentation pain (neuropathic pain), and even anaesthesia dolorosa [2].