Comparison of Different Local Anesthetics in Cervical Facet Medial Branch Blockade.

Objective: Cervical medial branch blocks (CMBBs) are frequently used for the treatment of facet arthropathy. The present study compares the effectiveness of lidocaine and prilocaine in CMBB procedures.

Methods: Patients with facet arthropathy scheduled for CMBB were randomly divided into 2 groups who were administered a combination of 2 mg dexamethasone and either 1% lidocaine or 1% prilocaine with a total volume of 1 mL per level. All patients were assessed prior to the procedure (baseline), and at 1 hour, 1 week, and 1 month after the procedure using the Numeric Rating Scale-11 (NRS-11), Neck Disability Index (NDI), and patient satisfaction was evaluated at 1 hour, 1 week, and 1 month after the procedure.

Results: A total of 97 patients were included in the study (n = 49 in the lidocaine group and n = 48 in the prilocaine group). A significant decrease was noted in the NRS-11 and NDI scores recorded during all follow-up assessments in both groups (P < 0.001), while the NRS-11, NDI scores, and patient satisfaction did not statistically differ between groups at 1 hour, 1 week, and 1 month following the procedure (P ˃ 0.05).

Conclusions: CMMB achieved with either lidocaine or prilocaine decreased the recorded pain severity and disability scores to a similar degree. The selection of either lidocaine or prilocaine for CMBB is thus at the clinician's discretion.