Oral and Dental Disease Research Center, Department of Oral Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Clinical Neurology Research Center, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
Photobiomodul Photomed Laser Surg. 2023 Jun;41(6):272-276. doi: 10.1089/photob.2023.0023.
Trigeminal neuralgia is one of the most severe pain conditions that humans experience. Drug resistance is a challenging event during treatment that results in using higher doses of drugs or referring for neurosurgical treatment. Laser therapy is also an effective method for pain control. The aim of this study was to evaluate the effect of non-ablative non-thermal CO laser (NANTCL) on reducing pain in patients with drug-resistant trigeminal neuralgia (DRTN) for the very first time. Twenty-four patients with DRTN were randomly divided into laser and placebo groups. Patients in the laser group received NANTCL (10,600 nm, 1.1 W, 100 HZ, 20 sec) on trigger points that were covered with lubricant gel 3 days in a week for 2 weeks. The placebo group received sham laser. The patients were requested to grade their pain on a visual analog scale (VAS) immediately, 1 week, 1 month, and 3 months after treatment. In the laser group, the results revealed a significant decrease between the initial pain and the pain in all follow-up sessions. Only in three patients, 3 months after completion of laser therapy, pain returned to the initial level. In the control group, a significant difference was seen only between the pain of baseline and final session of laser irradiation. In laser group, the mean of pain (VAS) was lower than the placebo group in all follow-up sessions; however, it was only significant for 1 week after laser therapy. This study revealed that short-period application of NANTCL is effective for pain relief in patients with DRTN, especially those with extraoral trigger points. Clinical trial registration number: IRCT2013052113406N1.
三叉神经痛是人类经历的最严重的疼痛之一。药物抵抗是治疗过程中极具挑战性的事件，导致需要使用更高剂量的药物或转介神经外科治疗。激光治疗也是控制疼痛的有效方法。本研究首次评估了非消融非热 CO 激光（NANTCL）对降低药物抵抗性三叉神经痛（DRTN）患者疼痛的效果。24 例 DRTN 患者随机分为激光组和安慰剂组。激光组患者在触发点接受 NANTCL（10,600nm，1.1W，100HZ，20sec）治疗，每周 3 天，在涂有润滑剂凝胶的触发点上治疗 2 周。安慰剂组接受假激光治疗。要求患者在治疗后立即、1 周、1 个月和 3 个月用视觉模拟量表（VAS）对疼痛进行评分。激光组结果显示，与初始疼痛相比，所有随访期的疼痛均显著下降。仅在激光治疗完成 3 个月后，有 3 例患者的疼痛恢复到初始水平。在对照组中，仅在基线疼痛和激光照射的最后一次随访中观察到显著差异。在激光组，所有随访期的疼痛（VAS）均值均低于安慰剂组，但仅在激光治疗后 1 周有显著差异。本研究表明，NANTCL 的短期应用对 DRTN 患者的疼痛缓解有效，尤其是那些有口腔外触发点的患者。临床试验注册号：IRCT2013052113406N1。
