The Nursing of Radiofrequency thermocoagulation of extracranial non-semilunar ganglion for trigeminal neuralgia

Objective To investigate the nursing approach for patients who receive radiofrequency thermocoagulation of extracranial non-semilunar ganglion through percutaneous puncture guided by CT to treat primary trigeminal neuralgia. Methods Retrospective analysis and summary have been carried out for clinical operations and nursing documentation of 218 cases of radiofrequency thermocoagulation of extracranial non-semilunar ganglion to treat primary trigeminal neuralgia in department of pain management in the First Hospital of Jiaxing from January,2013 to June,2015.The operations were conducted by percutaneous puncture under CT guidance through the foramen supraorbitale,foramen ovale,or foramen rotundum.We focused on preoperative nursing preparation,intraoperative nursing cooperation and postoperative nursing observation and treatment,in order to summarize the best nursing program and improve the treatment effect and patient satisfaction. Results The 218 cases of primary trigeminal neuralgia were divided into 17 cases of pain from Ⅰ,89 cases of Ⅱ,74 cases of Ⅲ,13 cases of Ⅰ+Ⅱ,25 cases of Ⅱ+Ⅲ,receiving radiofrequency thermocoagulation of extracranial non-semilunar ganglion following CT guided percutaneous puncture through foramen supraorbitale,foramen rotundum,foramen ovale,foramina supraorbitale plus rotundum,and foramina rotundum plus ovale respectively.The pain disappeared immediately after single treatment in 215 cases.There were 3 patients who had residual pain,which disappeared after second radiofrequency treatment.Various degree of numbness in the original pain area after treatment was reported in all cases.Various degree of difficulty in opening the mouth was observed after radiofrequency thermocoagulation of Ⅲ nerve.Facial swelling was observed in 29 cases after operation,and was timely detected by nursing care of postoperative,which disappeared after sequential hot and cold compression therapy.There were no reports on the damage to the other trigeminal nerve branches responsible for the pain or other complications. Conclusion The analgesic effectiveness of CT guided radiofrequency thermocoagulation of extracranial trigeminal nerve non-semilunar ganglion has been confirmed.Complications are limited to facial swelling and feeling numbness in the original pain area.The psychology nursing care and adequate preparations before the operation,vital sign monitoring during the operation,careful observation on the patient's condition after medication and operation,and good health communication and education are key methods to ensure the effective therapy and patient satisfaction.