计算机断层扫描引导下脉冲射频治疗眶下神经顽固性神经痛的有效性和安全性：一项初步研究

Effectiveness and Safety of Pulsed Radiofrequency Treatment Guided by Computed Tomography for Refractory Neuralgia of Infraorbital Nerve: A Pilot Study.

作者信息

Luo Fang, Lu Jingjing, Shen Ying, Meng Lan, Wang Tao, Ji Nan

机构信息

Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Pain Physician. 2015 Sep-Oct;18(5):E795-804.

PMID:26431133

Abstract

BACKGROUND

There is no truly optimal treatment to cure refractory neuralgia of the infraorbital nerve. Recently, nondestructive pulsed radiofrequency (PRF) has become one of the most attractive interventional techniques for painful disorders. However, use of the technique for infraorbital neuralgia has been seldom reported.

OBJECTIVE

The purpose of this prospective study is to observe the effectiveness and safety of PRF treatment for neuralgia of the infraorbital nerve.

STUDY DESIGN

Prospective case series clinical outcome study.

SETTING

University Medical Center, Beijing, China.

METHODS

From January 2011 to November 2012, 36 consecutive patients, following ineffective conservative therapy, underwent PRF treatment and completed 2-year follow-up. Numeric rating scales (NRS), effective rate, additional carbamazepine dosage, and side effects were recorded at postoperative day one, week one, week 2, month one, month 3, month 6, year one, and year 2. Patients were divided into effective group and ineffective group based on postoperative one -month total pain relief or more than 50% reduction in NRS and patients were satisfied with the effect, and possible factors affecting efficacy were compared between the 2 groups.

RESULTS

Effective rates were 69%, 69%, 64%, 50%, and 50% at postoperative month one, month 3, month 6, year one, and year 2, respectively. No serious side effects were observed, except that 9 patients felt short-term (one -month duration) mild numbness. Output voltage and tissue resistance in the effective group were significantly higher than the ineffective group (P < 0.01). Intraoperative output voltage was negatively correlated with postoperative one -month NRS (r = -0.332, P < 0.05).

LIMITATIONS

The non-controlled and single-centered design of the study.

CONCLUSIONS

Results demonstrated PRF treatment under computed tomography (CT) guidance for infraorbital neuralgia is safe, effective, and is expected to become an alternative for patients experiencing ineffective conservative therapy. Increasing the output voltage of PRF could be the chosen method to improve the efficacy.

摘要

背景

目前尚无真正理想的治疗方法来治愈难治性眶下神经痛。近年来，非破坏性脉冲射频（PRF）已成为治疗疼痛性疾病最具吸引力的介入技术之一。然而，该技术用于眶下神经痛的报道较少。

目的

本前瞻性研究旨在观察PRF治疗眶下神经痛的有效性和安全性。

研究设计

前瞻性病例系列临床结局研究。

研究地点

中国北京的大学医学中心。

方法

2011年1月至2012年11月，36例经保守治疗无效的患者接受PRF治疗，并完成了2年随访。记录术后第1天、第1周、第2周、第1个月、第3个月、第6个月、第1年和第2年的数字评分量表（NRS）、有效率、卡马西平额外用量及副作用。根据术后1个月疼痛完全缓解或NRS降低50%以上且患者对疗效满意，将患者分为有效组和无效组，比较两组间可能影响疗效的因素。