The efficacy and safety of combined pulsed and conventional radiofrequency treatment of refractory cases of idiopathic trigeminal neuralgia: a retrospective study

• Published in: Journal of anesthesia 2015-10, Vol.29 (5), p.728-733
• Main Authors: Ali Eissa, Ali A., Reyad, Raafat M., Saleh, Emad G., El-Saman, Amr
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analgesics; Anesthesiology; Care and treatment; Critical Care Medicine; Diagnosis; Dosage and administration; Emergency Medicine; Female; Humans; Intensive; Male; Medicine; Medicine & Public Health; Middle Aged; Needles; Original Article; Pain Management - methods; Pain Measurement - methods; Pain Medicine; Pulsed Radiofrequency Treatment - methods; Retrospective Studies; Trigeminal neuralgia; Trigeminal Neuralgia - therapy
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-015-2029-5

Purpose We conducted a retrospective study to evaluate the efficacy and duration of pain relief for idiopathic trigeminal neuralgia (TN) patients after continuous radiofrequency (CRF) combined with pulsed radiofrequency (PRF) treatment of the Gasserian ganglion (GG). Methods Twenty-one patients were treated with pulsed RF for 6 min repeated after rotating the needle tip by 180°, at a pulse width of 10 ms and at 45 °C. This was followed by conventional RF at 60 °C for 60 s, repeated after needle rotation by 180°, then finally at 65 °C for 60 s also repeated after needle rotation by 180°. Patients were assessed for pain intensity and consumption of analgesics at baseline and 7 days, 1 month, 6 months, and 12 months after the procedure. The patients’ global impression of change (PGIC) scale was also assessed 7 days, 1 month, 6 months, and 12 months after the procedure. The incidence of facial dysthesia was evaluated 7 days after the procedure. Results Excellent pain relief was achieved for 15 of 21 patients (71.4 %) after 1 week, 1 month, and 6 months. and for 14 of 21 patients (66.7 %) after 12 months. Consumption of analgesics was significantly reduced for more than 6 months, and for fifteen patients the PGIC scale result was very much improved 12 months after the procedure compared with baseline. Eighteen of the 21 patients (85.7 %) experienced facial dysthesia 1 week after the procedure. Conclusion Excellent pain relief and reduced consumption of analgesics for more than 6 months were observed in patients who received PRF combined with CRF to the GG for treatment of idiopathic TN.