Trigeminal nerve block with alcohol for medically intractable classic trigeminal neuralgia: long-term clinical effectiveness on pain
| Autor: | Kyung Ream Han, Jung Dong Lee, Chan Kim, Yun Jeong Chae |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Adolescent Clinical effectiveness One Hundred Fifty Alcohol Kaplan-Meier Estimate neurolysis Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Trigeminal neuralgia Humans Pain Management Medicine Trigeminal nerve block Neurolysis Aged Aged 80 and over trigeminal neuralgia Ethanol alcohol business.industry Nerve Block 030206 dentistry General Medicine Middle Aged medicine.disease Surgery trigeminal nerve block Treatment Outcome chemistry Anesthesia Female business Complication 030217 neurology & neurosurgery Research Paper |
| Zdroj: | International Journal of Medical Sciences |
| ISSN: | 1449-1907 |
| DOI: | 10.7150/ijms.16964 |
| Popis: | Background: Trigeminal nerve block (Tnb) with alcohol for trigeminal neuralgia (TN) may not be used widely as a percutaneous procedure for medically intractable TN in recent clinical work, because it has been considered having a limited duration of pain relief, a decrease in success rate and increase in complications on repeated blocks. Objectives: To evaluate the clinical outcome of the Tnb with alcohol in the treatment of medically intractable TN. Methods: Six hundred thirty-two patients were diagnosed with TN between March 2000 and February 2010. Four hundred sixty-five out of 632 underwent Tnb with alcohol under a fluoroscope. Pain relief duration were analyzed and compared in the individual branch blocks. Outcomes were compared between patients with and without a previous Tnb with alcohol. Results: Tnb with alcohol were performed in a total 710 (1st-465, 2nd-155, 3rd-55, 4th-23, 5th-8, 6th-4) cases for a series of consecutive 465 patients during the study period. Forty hundred sixty two out of the 465 patients experienced immediate complete pain relief (99%) at the first Tnb. Of the 465 patients, 218 patients (46.9%) did not require any further treatment after the first Tnb with alcohol during an entire study period. One hundred fifty nine (34.2 %) out of the 465 patients experienced recurring pain after the first block, among whom 155 patients received subsequent blocks, and the remaining 4 patients decided to take medication. According to the Kaplan-Meier analysis, the probabilities of remaining pain relief for 1, 2, 3, and 5 years after the procedures were 86.2%, 65.5%, 52.5%, and 33.4%, respectively. There was no significant difference in the probability of pain relief duration between patients with and without previous Tnb with alcohol. Median (95% CI) pain relief durations of the first and repeated blocks were 39 (36-51) and 37 (28-54) months, respectively. There was no significant difference in occurrence of complications between patients with and without previous Tnb with alcohol (p |
| Databáze: | OpenAIRE |
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