Analyzing the Effect of Intraoperative Stimulation Voltage on Facial Numbness Following Radiofrequency Thermocoagulation in the Treatment of Idiopathic Trigeminal Neuralgia.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2024-06-01 Epub Date: 2024-03-15 DOI:10.1007/s40122-024-00587-5

Aitao Wang, Jingjing Bian, Na Li, Jiaxiang Ni, Lea Zila, Yuanzhang Tang

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引用次数: 0

Abstract

Introduction: Radiofrequency thermocoagulation (RFT) effectively alleviates idiopathic trigeminal neuralgia (ITN); however, postoperative facial numbness poses a significant challenge. This issue arises due to the close proximity of high-temperature thermocoagulation, which not only ablates pain-related nociceptive fibers but also affects tactile fibers. Intraoperative sensory stimulation voltage (SV), which reflects the distance between the RFT cannula and the target nerve, potentially possesses the ability to prevent tactile fiber injury. This study aimed to investigate the influence of SV on postoperative facial numbness and provide valuable insights to mitigate its occurrence.

Methods: A retrospective analysis was performed on 72 ITN patients with maxillary division (V2) pain who underwent RFT between 2020 and 2022. Among them, 13 patients with SV ≤ 0.2 V constituted the low SV group. Subsequently, a matched-cohort analysis was conducted on the remaining 59 patients. The patients paired with the low SV patients were subsequently enrolled in the high SV group, adhering to a 1:1 match ratio. The primary outcome was the facial numbness scale assessment at 3 days, 3 months and 6 months post-surgery. The pain intensity and medication burden served as the secondary outcomes.

Results: We successfully matched a cohort consisting of 12 patients in the low SV group and 12 patients in the high SV group. Each patient experienced various degrees of facial numbness at 3 days post-RFT. Notably, the low SV group exhibited a higher incidence of moderate numbness (66.7% vs. 16.67%, P = 0.036), whereas the high SV group had more cases of mild numbness at the 6-month follow-up (25% vs. 83.3%, P = 0.012). Both groups demonstrated significant decreases in pain intensity and medication burden compared to before the operation.

Conclusions: SV proved to be a reliable parameter for mitigating the degree of postoperative facial numbness in RFT treatment for ITN. A relatively high sensory SV ranging from 0.3 to 0.6 V during the RFT procedure results in less facial numbness in the treatment of ITN.

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分析射频热凝术治疗特发性三叉神经痛后术中刺激电压对面部麻木的影响

简介：射频热凝术（RFT）能有效缓解特发性三叉神经痛（ITN），但术后面部麻木是一个重大挑战。造成这一问题的原因是高温热凝距离很近，不仅会消融与疼痛相关的痛觉纤维，还会影响触觉纤维。术中感觉刺激电压（SV）反映了 RFT 插管与靶神经之间的距离，具有防止触觉纤维损伤的潜在能力。本研究旨在探讨 SV 对术后面部麻木的影响，并为减轻术后面部麻木的发生提供有价值的见解：对 2020 年至 2022 年期间接受 RFT 的 72 例上颌分部（V2）疼痛的 ITN 患者进行了回顾性分析。其中，13 例 SV ≤ 0.2 V 的患者构成低 SV 组。随后，对其余 59 名患者进行了配对队列分析。与低 SV 患者配对的患者随后被纳入高 SV 组，配对比例为 1:1。主要结果是手术后 3 天、3 个月和 6 个月的面部麻木量表评估。疼痛强度和用药负担是次要结果：我们成功匹配了由 12 名低 SV 组和 12 名高 SV 组患者组成的队列。每位患者在 RFT 术后 3 天都会出现不同程度的面部麻木。值得注意的是，低 SV 组的中度麻木发生率更高（66.7% 对 16.67%，P = 0.036），而高 SV 组在 6 个月的随访中轻度麻木的病例更多（25% 对 83.3%，P = 0.012）。与手术前相比，两组患者的疼痛强度和用药负担都明显减轻：SV 被证明是减轻 ITN RFT 治疗术后面部麻木程度的可靠参数。在 RFT 治疗过程中，如果感觉 SV 值在 0.3 到 0.6 V 之间，那么治疗 ITN 时面部麻木的程度会相对较轻。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.