Predictors of the Analgesic Efficacy of CT-Guided Percutaneous Pulsed Radiofrequency Treatment of Gasserian Ganglion in Patients With Idiopathic Trigeminal Neuralgia.

Abstract

Although pulsed radiofrequency (PRF) has few postoperative adverse reactions, its analgesic efficacy for trigeminal neuralgia (TN) is not always guaranteed. The response rate of PRF targeting the Gasserian ganglion for patients with TN varies. This study aims to identify the predictors of the analgesic efficacy of CT-guided percutaneous PRF in patients with idiopathic TN. The patients with idiopathic TN who failed to respond to conservative treatment and underwent CT-guided percutaneous PRF treatment of the Gasserian ganglion from July 2008 to August 2018 at our pain clinic were screened. A positive response was defined as a ≥50% reduction in the pain numeric rating scale (NRS) score from baseline. The demographics and other pretreatment clinical data were analyzed by logistic regression analysis to identify the predictors of a positive response. Of the total 102 patients with idiopathic TN who were evaluated in this study, 57 patients (55.9%) were positively responsive to our treatment after 1year. The binary logistic regression analysis revealed that the positive response to a prior peripheral branch nerve block of the trigeminal nerve with steroid and local anesthetic agents was an independent predictor of the analgesic efficacy of PRF treatment (odds ratio [OR]=3.685, 95% confidence interval [CI]=1.583 to 8.577, P=0.002). The disease duration of TN was also included in the multivariate regression model, although the P value was 0.058 (OR 0.807, 95% CI 0.646 to 1.007). For patients who previously had positive responses to peripheral branch nerve block of the trigeminal nerve, PRF is likely to have better efficacy.