ĐAU DÂY THẦN KINH V KHÔNG ĐIỂN HÌNH: HIỆU QUẢ PHONG BẾ HẠCH CÁNH KHẨU DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

Objective: Atypical Trigeminal Neuralgia (ATN) is a type of chronic facial pain characterized by a dull, burning, and continuous pain, different from the typical paroxysmal pain. The disease has a major impact on the patient's quality of life and ability to function. Ultrasound-guided pterygopalatine ganglion block (PPGB) is a minimally invasive intervention technique, expected to bring effective pain relief to drug-resistant patients. To evaluate the effectiveness and safety of ultrasound-guided pterygopalatine ganglion block in the treatment of atypical trigeminal neuralgia. Subjects and methods: A prospective, single-center observational study conducted at the University of Medicine and Pharmacy Hospital, Ho Chi Minh City, from August 2024 to August 2025, including 32 ATN patients, of which 30 patients completed 12 weeks of follow-up. Patients underwent acromioclavicular ganglion block using a mixture of bupivacaine 0.5% (2–3 mL) and dexamethasone 2 mg, under ultrasound guidance via the subzygomatic approach. Pain severity was assessed by the NRS scale, quality of life by the SF-36, and patient satisfaction. Results: The mean NRS score decreased from 7.8 ± 1.1 to 2.7 ± 1.3 after 12 weeks (p < 0.001). The proportion of patients achieving ≥50% pain relief was 73.3% at week 1, 83.3% at week 4, and 86.7% at week 12. There were no serious complications; 16.7% of patients experienced transient maxillary numbness. 83.3% of patients were “very satisfied” with the procedure. Conclusion: Ultrasound-guided acromioclavicular ganglion block is a safe and effective method in the treatment of atypical trigeminal neuralgia, significantly reducing pain, improving quality of life and reducing the need for pain medication.