Koning Mark V, Koning Nick J, Koning Henk M, van Kleef Maarten
Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Departments of Anesthesiology and Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
Pain Pract. 2014 Sep;14(7):581-7. doi: 10.1111/papr.12124. Epub 2013 Oct 24.
The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) treatment of the trigeminal ganglion for treating patients with trigeminal neuralgia, to determine which patients have a long-term benefit, and to evaluate the effect of RF parameters.
A retrospective study in 28 consecutive patients in combination with a follow-up questionnaire (n = 26, 93% response).
An initial treatment effect of 89% was observed, 60% sustained at 12-month follow-up. Major side effects were hypesthesia (56%), dry eye (20%), and masseter muscle weakness (12%). A lower sensory stimulation threshold during treatment was associated with better patient satisfaction (P = 0.016), improved pain relief (P = 0.039), and trended toward more hypesthesia (P = 0.077).
This low-volume study reported treatment effects in an older population that were similar to previous studies. Only a higher incidence of hypesthesia was detected by long-term follow-up. This study supported the high efficiency of RF treatment, but there was a high level of side effects. Most notable, low sensory stimulation was associated with increased hypesthesia, whereas higher stimulation levels yielded less effectiveness. Further investigation of an optimal sensory stimulation range for percutaneous RF treatment of the trigeminal ganglion was found to be warranted.
本研究的目的是确定经皮射频(RF)治疗三叉神经节对三叉神经痛患者的疗效,确定哪些患者能获得长期益处,并评估射频参数的影响。
对28例连续患者进行回顾性研究,并结合随访问卷(n = 26,应答率93%)。
观察到初始治疗有效率为89%,在12个月随访时为60%。主要副作用为感觉减退(56%)、干眼(20%)和咬肌无力(12%)。治疗期间较低的感觉刺激阈值与更好的患者满意度相关(P = 0.016)、疼痛缓解改善(P = 0.039),且感觉减退有增加趋势(P = 0.077)。
这项小样本研究报告的老年人群治疗效果与先前研究相似。长期随访仅发现感觉减退的发生率较高。本研究支持射频治疗的高效性,但副作用水平较高。最值得注意的是,低感觉刺激与感觉减退增加相关,而较高刺激水平效果较差。有必要进一步研究经皮射频治疗三叉神经节的最佳感觉刺激范围。