A comparative study of gentamicin and triamcinolone acetonide for the treatment of primary trigeminal neuralgia

Abstract

Objective To observe the therapeutic effects and adverse events of gentamicin and triamcinolone acetonide on primary trigeminal neuralgia. Methods Forty patients with primary trigeminal neuralgia were allocated into two groups to receive a peripheral nerve block with lidocaine combined with gentamicin (gentamicin group) or triamcinolone aeetonide (triamcinolone acetonide group), respectively,once a week for 5 weeks. The pain intensity were assessed using visual analogue scale (VAS) before treatment and once a week just prior to every treatment, continued to make such assessment every month until 3 months after treatment. The pain relief rate and the occurrence of adverse events were also evaluated.Results The VAS of patients in two groups decreased significantly after treatment (P < 0.01). Compared with triamcinolone aeetonide group, the VAS in gentamicin group were higher during the early 3 weeks after treatment (P< 0.05 or < 0.01). At the observing point of 2, 3 months after treatment, the VAS in gentamicin group were lower than that in triamcinolone acetonide group(P< 0.01). The effective rate in gentamicin group was lower than that in triamcinolone acetonide group during the early 2 weeks after treatment, the clinical cure rate in gentamicin group was higher than that in triamcinolone aeetonide group at the observing point of 2, 3 months (70% and 60% vs 15% and 5%). Conclusion Compared with the triamcinolone aeetonide, the therapy of the gentamicin has slower onset time and longer sedative duration, has no corticosteroids-related side effect, and also has the possibility of repeat blocking time after time. Key words: Trigeminal neuralgia; Comparative study; Gentamicins; Triamcinolone acetonide