A retrospective analysis of efficacy of neural blockade in treating severe extracranial neuralgia after craniotomy in 33 patients / 中华麻醉学杂志

ABSTRACT

Thirty-three patients with severe extracranial neuralgia after craniotomy(21 male, 12 female), aged 20-59 yr, in whom drug treatment was ineffective, 27 patients with headache following a-cute craniotomy(within 3 months)and 6 patients with headache after long-time craniotomy(more than 3 months)underwent neural blockade from January 2010 to March 2017 in Pain Clinic at our hospital. Their treatment and outcomes were analyzed retrospectively. The solution for neural blockade contained triamcin-olone acetonide 10 ml and 0.4% lidocaine solution and was injected into each puncture site(1-3 ml). Pain scores were decreased after the initial neural blockade when compared with that before therapy. Among the 27 patients with headache after acute craniotomy, there were 26 patients(96%)in whom complete pain relief was achieved only after one block and 1 patient(4%)after 2 times of block. Among the 6 pa-tients with headache after long-time craniotomy, there were 3 patients(50%)in whom complete pain re-lief was achieved after 2 times of block, 2 patients(33%)after 3 times and 1 patient(17%)after 4 times. The average time of achieving complete pain relief was 5(1-30)days. No recurrence was found during one-month follow-up period. No infection at the puncture site, injection pain or related adverse reac-tions after application of steroid hormones was observed. Neural blockade can be safely and effectively used to treat severe extracranial neuralgia after craniotomy.