A Novel Sequential Percutaneous Radiofrequency Treatment Strategy for Drug-refractory Trigeminal Neuralgia: A Propensity Score-matched Study.

IF 2.6 2区医学 Q2 ANESTHESIOLOGY

Pain physician Pub Date : 2024-09-01

Hao Ren, Yang Wang, Zheng Chen, Yan Zhang, Guo Feng Ma, Fang Luo

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引用次数: 0

Abstract

Background: Gasserian ganglion-targeted conventional and pulsed radiofrequency treatments are percutaneous procedures performed for drug-refractory trigeminal neuralgia. However, ideal outcomes are not always achieved with these procedures; frequent postprocedural complications and therapeutic ineffectiveness are also of major concern.

Objectives: This study was conducted to investigate a novel strategy for effective, uncomplicated pain relief in patients with drug-refractory trigeminal neuralgia.

Study design: A multicenter, retrospective, observational study.

Setting: Participating centers were Beijing Tiantan Hospital and Sanbo Brain Hospital.

Methods: From January 2010 through December 2019, a total of 2,087 patients with drug-refractory trigeminal neuralgia were included in the current study. Of them, 143 underwent sequential conventional radiofrequency treatment and 1,944 underwent conventional radiofrequency treatment only. The primary outcome was being pain free at 24 months postprocedure; multiple secondary outcomes were compared between treatments before and after propensity score matching.

Results: At the 24-month follow-up, sequential radiofrequency treatment provided a higher pain-free outcome than conventional radiofrequency treatment (0.93 [95% CI, 0.92-0.94]) vs 0.89, (95% CI, 0.84-0.94; P = 0.04); hazard ratio, 1.703 (95% CI, 1.01-2.86). For the 124 propensity score-matched pairs, there was no significant difference between groups, although pain-free outcomes were numerically higher in the sequential radiofrequency treatment group (0.93 [95% CI, 0.89-0.98]) vs 0.90 (95% CI, 0.85-0.96; P = 0.3); hazard ratio, 0.653 (95% CI, 0.27-1.60). Notably, sequential radiofrequency treatment correlated with fewer overall postprocedural complications than conventional radiofrequency treatment, despite propensity score matching analysis (14/143 vs 723/1944, relative risk, 0.69 (95% CI, 0.65-0.74; P < 0.001); 11/124 vs 45/124, relative risk 0.69 (95% CI, 0.60-0.80; P < 0.001).

Limitations: Procedural parameters and quality of life evaluation by treatment were not analyzed and cost data were not collected.

Conclusion: Sequential radiofrequency treatment has the potential to provide effective, uncomplicated, pain-free outcomes.

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治疗药物难治性三叉神经痛的新型序贯经皮射频治疗策略：倾向评分匹配研究

背景：以 Gasserian 神经节为靶点的传统和脉冲射频治疗是治疗药物难治性三叉神经痛的经皮手术。然而，这些治疗方法并不总能取得理想的疗效，术后并发症频发和治疗效果不佳也是主要问题：本研究旨在探讨一种新策略，以有效缓解药物难治性三叉神经痛患者的疼痛：多中心、回顾性、观察性研究：参与中心：北京天坛医院和三博脑科医院：方法：自2010年1月至2019年12月，共有2087名药物难治性三叉神经痛患者纳入本次研究。其中，143人接受了序贯常规射频治疗，1944人仅接受了常规射频治疗。主要结果是治疗后 24 个月无痛；对倾向评分匹配前后的治疗方法进行了比较：在 24 个月的随访中，序贯射频治疗的无痛结果高于常规射频治疗（0.93 [95% CI, 0.92-0.94]) vs 0.89, (95% CI, 0.84-0.94; P = 0.04)；危险比为 1.703 (95% CI, 1.01-2.86)。在 124 对倾向评分匹配组中，虽然序贯射频治疗组的无痛疗效在数字上更高（0.93 [95% CI, 0.89-0.98]) vs 0.90 (95% CI, 0.85-0.96; P = 0.3)；危险比为 0.653 (95% CI, 0.27-1.60)，但组间无显著差异。值得注意的是，尽管进行了倾向评分匹配分析，但序贯射频治疗与传统射频治疗相比，术后总体并发症更少（14/143 vs 723/1944，相对风险0.69（95% CI，0.65-0.74；P < 0.001）；11/124 vs 45/124，相对风险0.69（95% CI，0.60-0.80；P < 0.001）：局限性：未对治疗过程参数和生活质量评估进行分析，也未收集成本数据：结论：序贯射频治疗具有提供有效、简便、无痛疗效的潜力。

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 physician CLINICAL NEUROLOGY-CLINICAL NEUROLOGY

CiteScore

6.00

自引率

21.60%

发文量

234

期刊介绍： Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year. Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.