Volume 19 Issue 1
Jan.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(1): 141-145
CHEN Dong-liang, ZHONG Jun-feng, HUANG Bing, ZHANG Li, REN Xiao-mei, YAO Ming, DENG Jia-jia. Procedure and monitoring management of extracranial radiofrequency thermocoagulation for trigeminal neuralgia[J]. Chinese Journal of General Practice, 2021, 19(1): 141-145. doi: 10.16766/j.cnki.issn.1674-4152.001751
Citation: CHEN Dong-liang, ZHONG Jun-feng, HUANG Bing, ZHANG Li, REN Xiao-mei, YAO Ming, DENG Jia-jia. Procedure and monitoring management of extracranial radiofrequency thermocoagulation for trigeminal neuralgia[J]. Chinese Journal of General Practice, 2021, 19(1): 141-145. doi: 10.16766/j.cnki.issn.1674-4152.001751
shu

Procedure and monitoring management of extracranial radiofrequency thermocoagulation for trigeminal neuralgia

doi: 10.16766/j.cnki.issn.1674-4152.001751
  • 1.

    Department of Pain Medicine, The The First Hospital of Shaoxing, Shaoxing, Zhejiang 312000, China

Funds:

 2016ZDA018

 2019ZH046

 2018AY32010

  • Received Date: 2019-08-12
    Available Online: 2022-02-19
    Abstract
  •   Objective  By comparing the effects of local anesthesia and total intravenous anesthesia in the treatment of trigeminal neuralgia by extracranial non-Gasserian ganglia radiofrequency thermocoagulation, the optimal comfortable medical process and monitoring management measures were selected.  Methods  A total of 150 patients with trigeminal neuralgia scheduled for radiofrequency thermocoagulation of extracranial non-Gasserian ganglia were randomly divided into three groups with random number table method: group A received no anesthetic intervention except local anesthesia at puncture point; The others received intravenous injection of dexmedetomidine (0.3 μg/kg), after electrophysiological tests were correct, group B received injection of 2% lidocaine 0.5 mL through radiofrequency needle; In group C, propofol was injected intravenously 1.0-1.5 mg/kg. Then radiofrequency therapy was performed after patients fell asleep. The corresponding vasoactive drugs such as urapidil, ephedrine and atropine were given to maintain circulation stability according to the changes of blood pressure, heart rate and oxygen saturation during operation. The blood pressure, heart rate, oxygen saturation, intraoperative dosage of drugs, intraoperative complications, short-term efficacy and patient satisfaction were recorded.  Results  Blood pressure and heart rate in group A were significantly higher than the baseline values during treatment, and at T1 (Puncture operation) and T2 (radiofrequency thermocoagulation 60 s), blood pressure and heart rate in group A were significantly higher than those in group B and C (all P < 0.05), respectively. 68% of patients in group A needed vasoactive drugs to control blood pressure during treatment, and comfort satisfaction in group C was significantly higher than those in group A and B (all P < 0.05).  Conclusion  When patients with trigeminal neuralgia are treated with extracranial radiofrequency thermocoagulation, dexmedetomidine injection before puncture and propofol injection before radiofrequency can greatly improve the comfort and satisfaction of radiofrequency therapy, without affecting the short-term efficacy judgement, but they need oxygen inhalation and monitoring, and use vasoactive drugs to maintain circulation stability when necessary to ensure safety.

     

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