Department of Pain Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, Province Jiangsu, China.
BMC Anesthesiol. 2022 Apr 11;22(1):104. doi: 10.1186/s12871-022-01644-2.
Radiofrequency thermocoagulation of Gasserian ganglion brings with it the difficult problem of how to provide adequate acesodyne therapy for patients in order to make the treatment more comfortable. In our study, we assess the safety and efficacy of lidocaine local anesthesia in the treatment of trigeminal neuralgia.
From January, 2017 to December, 2020, 80 patients in our hospital who were suffering from trigeminal neuralgia were treated with radiofrequency thermocoagulation through oval foramen. They were all enrolled in our study and randomly divided into a study group and a placebo group. In the study group an appropriate concentration of lidocaine was given outside and inside of the oval foramen after puncturing in place, while in the placebo group the same dose of normal saline was given in the same way. We then recorded the mean arterial pressure (MAP), heart rate (HR) and visual analogue scale (VAS) at different treatment temperatures.
The values of MAP and HR in the study group were generally lower than those in the placebo group, and the difference was statistically significant. Additionally, the two groups showed a significant difference in MAP, HR, and VAS at different treatment temperatures. There were significant differences in MAP and VAS between the study group at the baseline as well as each time point thereafter, and the range of MAP and HR in the study group were lower than those in the placebo group.
Reasonable lidocaine local anesthesia can provide analgesic effects and prevent hypertension and arrhythmia during Gasserian ganglion radiofrequency thermocoagulation for the treatment of trigeminal neuralgia.
射频热凝治疗神经节会带来如何为患者提供足够的镇痛治疗以使其治疗更为舒适的难题。在我们的研究中,我们评估了利多卡因局部麻醉在治疗三叉神经痛中的安全性和有效性。
2017 年 1 月至 2020 年 12 月,我院 80 例三叉神经痛患者经卵圆孔行射频热凝治疗,均纳入本研究,并随机分为研究组和安慰剂组。研究组穿刺到位后,在卵圆孔内外给予适当浓度的利多卡因,安慰剂组则以相同方式给予相同剂量的生理盐水。然后记录不同治疗温度下的平均动脉压(MAP)、心率(HR)和视觉模拟量表(VAS)。
研究组的 MAP 和 HR 值普遍低于安慰剂组,差异具有统计学意义。此外,两组在不同治疗温度下的 MAP、HR 和 VAS 均有显著差异。研究组在基线及此后各时间点的 MAP 和 VAS 均有显著差异,且研究组的 MAP 和 HR 范围均低于安慰剂组。
合理的利多卡因局部麻醉可以在治疗三叉神经痛的神经节射频热凝过程中提供镇痛效果,并预防高血压和心律失常。