Comparison of Balanced General and Total Intravenous Anaesthesia for Gasser Ganglion Percutaneous Balloon Microcompression for Trigeminal Neuralgia

Abstract

Objective: To compare the effectiveness between balanced general anaesthesia and total intravenous anaesthesia for the hemodynamic control of patients undergoing percutaneous balloon microcompression of the Gasser’s ganglion in trigeminal neuralgia. Patients and methods: A retrospective trial was conducted in thirty patients with the diagnosis of essential trigeminal neuralgia, aged 37 to 82 years old, ASA I and II. The participants were randomly allocated in two groups: Group A, to receive balanced general anaesthesia (BGA) with isoflurane/fentanyl, or Group B, to receive total intravenous anesthesia (TIVA) with propofol/remifentanil. The systolic, diastolic and mean arterial blood pressure, heart rate and oximetry were measured at basal state, entrance to Meckel’s cavum and during the balloon compression. Statistical analysis with the Student T test for continuous quantitative variables and x2 (Chi square) for qualitative variables was performed. Results: The systolic blood pressure was significantly higher in group A at the moment of greatest stimulation. The technique propofol/remifentanil (group B) obtained better hemodynamic control and its management was easier. The incidence of bradycardia was similar in both groups and kept inverse relation with use of previous atropine. Conclusions: Total intravenous anesthesia (TIVA) is an attractive alternative to balanced general anesthesia due to the better hemodynamic response and the quick recovery that this technique offers. Moreover, Atropine use before the procedure is a measure that could benefit patients