Observation Of Balloon Pressure And Curative Effect In Treating Primary Trigeminal Neuralgia With Percutaneous Balloon Compression

Purpose:This paper aims to analyze the relationship between balloon pressure and curative effect in the treatment of primary trigeminal neuralgia by grouping observation and follow-up based on intraoperative balloon pressure.Methods:Patients with primary trigeminal neuralgia who underwent local anesthesia for sober sedation and analgesic balloon compression in our hospital from December 2021 to September 2022 were retrospectively included.According to intraoperative balloon pressure,patients were divided into low pressure group(group P1)and high pressure group(group P2).In group P1,balloon pressure<170kPa and group P2,balloon pressure≥170kPa.General data(including gender,age,medical history,neurovascular compression and surgical history),balloon pressure,compression time,intraoperative puncture depth,puncture Angle,operation time,intraoperative cerebrospinal fluid(with/without),conjunctival congestion(with/without)and heart rate reduction(with/without),preoperative NRS score and postoperative NRS score of the two groups of patients were collected.The postoperative follow-up data of 1,3 and 6 months between the two groups were collected,and the rate of postoperative pain relief,mastication fatigue and facial numbness were compared between the two groups.Results:A total of 62 cases were included(P1 group,n=30,48.4%;P2 group,n=32,51.6%).The pressure of group P1 was 135.5±22.8kPa;The pressure of group P2 was 197.8±33.4kPa.The general data(including gender,age,medical history,neurovascular compression and surgical history),balloon pressure,compression time,intraoperative puncture depth,puncture Angle,operation time,intraoperative cerebrospinal fluid(with/without),conjunctival congestion(with/without)and heart rate deceleration(with/without)of the two groups were compared,and the difference was not statistically significant(p>0.05).Preoperative NRS score and postoperative NRS score were compared between the two groups,and the difference was statistically significant(p<0.05).The pain relief rate immediately after surgery,1 month after surgery,3 months after surgery and 6 months after surgery was compared between the two groups(100.0%vs.100.0%,83.3%vs.90.6%,76.7%vs.87.5%,70.0%vs.87.5%),and the difference was not statistically significant(p>0.05).The incidence of masticatory fatigue on the affected side was compared 1 month,3 months and 6 months after surgery(60.0%vs.93.8%,40.0%vs.81.3%,23.3%vs.65.6%),and the comparison between groups was statistically significant(p<0.05).The incidence of numbness on the affected side was compared 1 month,3 months and 6 months after surgery(73.3%vs.100%,56.7%vs.96.9%,53.3%vs.93.8%),and the difference was statistically significant(p<0.05).Conclusion:(1)Primary trigeminal neuralgia can be treated by balloon compression under awake analgesic monitoring under local anesthesia.(2)When PBC operation is performed under local anesthesia and wakeful state,the patient’s complaint of"numbness in the original pain area and disappearance of the original pain" can be regarded as the standard for the end of treatment,without deliberately observing whether the balloon is "pear shape".(3)There was no significant difference between the low pressure group(<170kPa)and the high pressure group(≥170kPa)in the pain relief rate within 6 months after surgery.The incidence of masticatory fatigue and facial numbness on the affected side was higher in the low pressure group and lower in the pressure group.