Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia

Background: Trigeminal neuralgia is a sudden, severe condition characterized by stabbing and recurrent pain. Radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) are common surgical interventions used to treat trigeminal neuralgia. This study aimed to investigate the therapeutic e...

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Main Authors: Nader Ali Nazemian Yazdi, Mehdi Sanatkar, Mohammad Sadegh Sanie Jahromi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2023-06-01
Series:Archives of Anesthesia and Critical Care
Subjects:
Online Access:https://aacc.tums.ac.ir/index.php/aacc/article/view/795
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author Nader Ali Nazemian Yazdi
Mehdi Sanatkar
Mohammad Sadegh Sanie Jahromi
author_facet Nader Ali Nazemian Yazdi
Mehdi Sanatkar
Mohammad Sadegh Sanie Jahromi
author_sort Nader Ali Nazemian Yazdi
collection DOAJ
description Background: Trigeminal neuralgia is a sudden, severe condition characterized by stabbing and recurrent pain. Radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) are common surgical interventions used to treat trigeminal neuralgia. This study aimed to investigate the therapeutic effects and associated complications of PRF in the treatment of trigeminal neuralgia. Methods: Pulsed radiofrequency was performed on 20 patients with primary trigeminal neuralgia. One months later, pain relief and complication status were evaluated. All patients who referred to the pain clinic of Amir Alam Hospital with a diagnosis of primary TN and after failure of conservative treatment or intolerance to drug side effects were candidates for trigeminal ganglion destruction by PRF method were the study population. Results: In this study, the female to male ratio was 1.5. The mean age of patients was 50.70 years. The highest prevalence was reported in 50-75 years (45%). 7 patients (35%) had pain in the right and 13 patients (65%) had pain in the left. In 18 patients there was involvement in one nerve root and in 2 patients there was involvement in 2 nerve roots. 1 patient (5%) had V1 root involvement, 13 patients (65%) had V2 root involvement and 8 patients (40%) had V3 root involvement. The mean pain score of patients before the procedure was 8.8. The mean pain of patients one hour after surgery was 3.95 and on days 7 and 30 after surgery were 3.3 and 4.25, respectively. One hour after the operation, effective pain relief was observed in 75% of patients. The effective response rate was observed one week after the procedure in 80% of patients and one month later in 60% of patients. There was no significant relationship between patients' gender and the effectiveness or ineffectiveness of the procedure after one month. With age, the effective response to treatment in patients increases. In 2 patients, infection was reported at the procedure site. Four patients reported paresthesia at the procedure site one month after surgery. Conclusion: PRF treatment was an effective, safe and non-destructive method for patients with TN. Primary PRF treatment can be considered as a first-line option before more invasive treatments, such as neurodegenerative procedures and MVD surgery.
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spelling doaj.art-0800589f5bff4724ac4512d05689d3132023-08-16T05:53:22ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492023-06-019310.18502/aacc.v9i3.13114Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal NeuralgiaNader Ali Nazemian Yazdi0Mehdi Sanatkar1Mohammad Sadegh Sanie Jahromi2Department of Anesthesiology and Pain, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology and Pain, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology and Pain, Jahrom University of Medical Sciences, Jahrom, Iran. Background: Trigeminal neuralgia is a sudden, severe condition characterized by stabbing and recurrent pain. Radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) are common surgical interventions used to treat trigeminal neuralgia. This study aimed to investigate the therapeutic effects and associated complications of PRF in the treatment of trigeminal neuralgia. Methods: Pulsed radiofrequency was performed on 20 patients with primary trigeminal neuralgia. One months later, pain relief and complication status were evaluated. All patients who referred to the pain clinic of Amir Alam Hospital with a diagnosis of primary TN and after failure of conservative treatment or intolerance to drug side effects were candidates for trigeminal ganglion destruction by PRF method were the study population. Results: In this study, the female to male ratio was 1.5. The mean age of patients was 50.70 years. The highest prevalence was reported in 50-75 years (45%). 7 patients (35%) had pain in the right and 13 patients (65%) had pain in the left. In 18 patients there was involvement in one nerve root and in 2 patients there was involvement in 2 nerve roots. 1 patient (5%) had V1 root involvement, 13 patients (65%) had V2 root involvement and 8 patients (40%) had V3 root involvement. The mean pain score of patients before the procedure was 8.8. The mean pain of patients one hour after surgery was 3.95 and on days 7 and 30 after surgery were 3.3 and 4.25, respectively. One hour after the operation, effective pain relief was observed in 75% of patients. The effective response rate was observed one week after the procedure in 80% of patients and one month later in 60% of patients. There was no significant relationship between patients' gender and the effectiveness or ineffectiveness of the procedure after one month. With age, the effective response to treatment in patients increases. In 2 patients, infection was reported at the procedure site. Four patients reported paresthesia at the procedure site one month after surgery. Conclusion: PRF treatment was an effective, safe and non-destructive method for patients with TN. Primary PRF treatment can be considered as a first-line option before more invasive treatments, such as neurodegenerative procedures and MVD surgery. https://aacc.tums.ac.ir/index.php/aacc/article/view/795Triple nerve neuralgiaRadiofrequencyPulse radiofrequency
spellingShingle Nader Ali Nazemian Yazdi
Mehdi Sanatkar
Mohammad Sadegh Sanie Jahromi
Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
Archives of Anesthesia and Critical Care
Triple nerve neuralgia
Radiofrequency
Pulse radiofrequency
title Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
title_full Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
title_fullStr Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
title_full_unstemmed Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
title_short Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia
title_sort evaluation of the effectiveness of trigeminal ganglion ablation using pulse radiofrequency in the treatment of trigeminal neuralgia
topic Triple nerve neuralgia
Radiofrequency
Pulse radiofrequency
url https://aacc.tums.ac.ir/index.php/aacc/article/view/795
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