Sproll Christoph, Turowski Bernd, Depprich Rita, Kübler Norbert R, Rapp Marion, Lommen Julian, Holtmann Henrik
Clinic for Oral and Maxillofacial Surgery, University Hospital, Heinrich-Heine-University, Moorenstraße 5, 40225 Düsseldorf, Germany.
Institute for Diagnostic and Interventional Radiology, Division of Neuroradiology, University Hospital, Heinrich-Heine-University, Moorenstraße 5, 40225 Düsseldorf, Germany.
Case Rep Med. 2018 May 24;2018:5247594. doi: 10.1155/2018/5247594. eCollection 2018.
Ganglionic local opioid analgesia (GLOA) describes the application of low-dose opioids close to sympathetic as, for example, to the superior cervical ganglion. GLOA can be effective in different pain syndromes affecting the head and face region and has been considered to be a safe technique with few complications reported so far. We present the case of a patient who received a single, transoral GLOA for a refractory trigeminal neuralgia. The patient subsequently developed an extensive epidural abscess at the craniocervical junction, requiring ultimately transoral odontoid resection and dorsal stabilisation. This severe complication challenges the role of transoral infiltration therapies in analgetic medicine.
神经节局部阿片类镇痛（GLOA）是指在靠近交感神经节（如颈上神经节）处应用低剂量阿片类药物。GLOA对影响头面部区域的不同疼痛综合征可能有效，并且迄今为止一直被认为是一种安全的技术，报告的并发症很少。我们报告一例患者，其因难治性三叉神经痛接受了单次经口GLOA治疗。该患者随后在颅颈交界处发生广泛的硬膜外脓肿，最终需要行经口齿状突切除术和后路稳定术。这一严重并发症对经口浸润疗法在镇痛医学中的作用提出了挑战。
