AI Article Synopsis

  • Trigeminal neuralgia (TN) is a painful condition with no ideal treatment; high-voltage pulsed radiofrequency (PRF) offers a new minimally invasive option but lacks robust clinical evidence.
  • A multicenter, double-blind randomized controlled trial evaluated the effectiveness and safety of high-voltage PRF compared to nerve blocks in TN patients who poorly responded to medication.
  • Results showed a significantly higher positive response rate (73.1%) for the PRF group after one year compared to the nerve block group (32.8%), suggesting that PRF may be a preferred treatment choice for these patients.

Article Abstract

Background: Trigeminal neuralgia (TN) is a debilitating pain disorder that still lacks an ideal treatment option. Pulsed radiofrequency (PRF), especially with high output voltage, is a novel and minimally invasive technique. PRF is regarded a promising treatment option for TN patients who respond poorly to medical treatment; however, the available evidence still lacks high quality randomized controlled trials (RCTs). Our study aimed to evaluate the long-term (1 year and 2 years) effects and safety of high-voltage PRF in primary TN patients and provide stronger evidence for TN treatment options.

Methods: We performed a multicenter, double-blind, RCT in adults (aged 18-75 years) with primary TN who responded poorly to drug therapy or were unable to tolerate the side effects of drug. Eligible participants were randomly assigned (1:1) to receive either high voltage PRF or nerve block with steroid and local anesthetic drugs. The primary endpoint was the 1-year response rate. This trial has been registered in the clinicaltrials.gov website (registration number: NCT03131466).

Results: One hundred and sixty-two patients were screened for enrollment between April 28th,2017 and September1st, 2019, among whom, 28 were excluded. One hundred and thirty-four participants were randomly assigned to either receive high voltage PRF (n = 67) or nerve block (n = 67). The proportion of patients with a positive response at 1-year after the procedure in the PRF group was significantly higher than that in the nerve block group in the intention-to-treat population (73.1% vs. 32.8%, p < 0.001). There was no difference between groups in the incidence of adverse events.

Conclusions: Our findings support that high voltage PRF could be a preferred interventional choice prior to receiving more invasive surgical treatment or neuro-destructive treatment for TN patients who have poor responses to medical treatment.

Trial Registration: Our study has been registered at ClinicalTrials.gov (trial registration number: NCT03131466).

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353218PMC
http://dx.doi.org/10.1186/s10194-023-01629-7DOI Listing

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