Kim Minkyung, Oh Yoomin, Kim Jeongsoo
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
J Pain Res. 2021 Feb 17;14:481-485. doi: 10.2147/JPR.S295211. eCollection 2021.
Maxillary nerve block is widely used for treating trigeminal neuralgia. Common complications of the procedure include bleeding and sensory abnormalities, but ophthalmic complications have been rarely reported. A 60-year-old woman underwent maxillary nerve block for refractory trigeminal neuralgia. Ten minutes after the procedure had ended, the patient reported double vision when she tried to turn the left eye outward. After examination, the patient was presumed to have diplopia due to the abducens nerve block. However, the symptom disappeared approximately 30 minutes later without any treatment. Thus, to prevent diplopia, the dose of local anesthetics should be reduced. Moreover, negative blood aspiration should be confirmed during the injection. To the best of our knowledge, this is the first case to report diplopia after maxillary nerve block without neurolysis through the lateral infrazygomatic approach.
上颌神经阻滞广泛应用于治疗三叉神经痛。该操作的常见并发症包括出血和感觉异常，但眼部并发症鲜有报道。一名60岁女性因难治性三叉神经痛接受上颌神经阻滞。操作结束10分钟后，患者试图向左眼外展时报告出现复视。检查后，推测患者因展神经阻滞而出现复视。然而，未经任何治疗，症状约30分钟后消失。因此，为预防复视，应减少局部麻醉剂的剂量。此外，注射过程中应确认回抽无血。据我们所知，这是首例通过外侧颧下入路在未进行神经松解的上颌神经阻滞后报告复视的病例。
