The efficacy of ganglionic local
opioid analgesia (GLOA) at the superior cervical ganglion (SCG) was retrospectively investigated in 74 consecutive patients with
neuropathic pain in the head and face region. It was possible to retrospectively analyze the short-term and medium-term treatment results in 64 of 74 patients. The long-term effect was subsequently determined using a standardized questionnaire. The short-term
analgesic effect of the first blockade by GLOA was significant with a mean
pain reduction of 52% (p < 0.001). Within a span of 20 min the mean
pain intensity decreased from 65 to 28 on a visual analogue scale. A clinically relevant
pain reduction (> or = 30%) was observed in 73% of the patients. The proportion of responders (
pain reduction > or = 50%) was 59% after the first blockade. Patients with
zoster or
trigeminal neuralgia experienced greater
pain relief than patients with atypical
facial pain or longer lasting postzoster
neuralgia. During the course of the blockade series with an average duration of 33 days, a significant medium-term
pain reduction of 30% was noted. In the first 3 treatment days, the level of continuous
pain declined from 6.3 to 4.3 on a numerical rating scale. Short-term responders reported a better medium-term
pain reduction than nonresponders. After 3 years (range: 5 months to 6 years), 21% of 52 patients remained free of
pain. The other patients reported often only minimal residual
pain or a decrease of
pain severity and duration. According to these results, GLOA at the SCG can represent a suitable and simple treatment option for neuropathic
facial pain.