Gasserian Ganglion Block With or Without Low-intensity Laser Therapy in Trigeminal Neuralgia

Abstract

Objective: Trigeminal neuralgia is a disabling syndrome characterized by severe hemifacial pain, often accompanied by a brief facial spasm. The treatment generally includes medical or surgical approaches. Low-level laser therapy (LLLT) has also been proposed as a safe and effective treatment modality. This study aims to assess whether adding LLLT to trigeminal ganglion block has a substantial effect in increasing pain relief in trigeminal neuralgia. Methods: This case-control study recruited 42 patients with trigeminal neuralgia over a 15-month period from a single academic pain center. The patients were randomized to 2 equal groups. Group A received Gasserian ganglion block along with LLLT, and group B, the control group, received only the ganglion block. The severity of pain was determined by the visual analogue scale at baseline, before each block, and at 1, 3, 5, and 7 days and 1, 3, and 6 months after the intervention. The dose of carbamazepine taken by the patients was also documented during the study period. The results were analyzed using SPSS v.15. The Student t test (independent samples), the Mann-Whitney U test, the χ2 test, and the Fisher exact test were used to analyze the results. P≤0.05 was considered significant. Results: The severity of pain was significantly lower in group A, from day 7 until the end of the study period (month 6). The number of carbamazepine tablets taken was also significantly lower in group A compared with group B from the initial months until the end of the study period (month 6). The period of a pain-free state was significantly higher in group A than in group B (P<0.00l). Conclusions: This study showed that LLLT augments the effects of ganglion block in patients with trigeminal neuralgia and results in a decrease in the dose of carbamazepin after the intervention. The duration of a painless state is also considerably long with this method.