Retrospective Analysis Of Adriamycln Interventioal Treatment On Trigeminal Neuralgia Via Foramen Ovale

Objective:To observe the comparisons of short-term and long-term therapeutic effects of adriamycin on trigeminal neuralgia undering different electric stimulation of nerve stimulator generating, employing the C arm X-ray machine and nerve stimulator dual guidance method.Methods:We emploied adriamycln interventional treatment on trigeminal neuralgia via foramen ovale under C arm X-ray machine and nerve stimulator dual guidance method,103trigeminal neuralgia patients who were received in our department between January2007and September2009, they were divided into three groups on the basis of different electric stimulation:Group A, the stimulating current is lower than0.1mA; Group B, the stimulating current is between0.1mAand0.4mA; Group C, the stimulating current is stronger than0.4mA. Therapeutic method, All the patients were in lateral position without pillow.with Conventional ECG monitoring, skin degerming、operative field outlining by sterile towels, and then the hollow outside the mouth was located by operator, with1%lidocaine local anesthetized, and then10puncture needle was puncturing towards basis cranii undering C line arm machine guiding, when the point of the needle approach to foramen ovale, connecting to the nerve stimulator, then getting into foramen ovale slowly with the C line arm machine guiding, and the stimulating current was recorded. When it was showed the needle tip in the foramen ovale, inject1%lidocaine0.5ml as the trail nerve block..15minutes later, if the patient would feel the pain was alleviative,without other abnormal symptoms or signs,injecting diprospan and0.5%adriamycin0.5ml slowly, then withdraw the needle, post band-aid,observe the patient have no discomfort.back him to the ward. Analyse and compare the total score of PRI、PPI、NRS of McGill and pain relief、sleep、the condition of taking analgesic and adverse effects what were recorded at1、2、4、8、16、24moth after treatment.Results:The difference in the total score of PRIof Group A(35patients) was statistically significant compared with Group C(30patients) at the16、24months. The differences in NRS、PPI、sleep Score of Group A was statistically significant compared with Group C at the24months (p<0.05) the differences in PRI of Group B between Group B (38patients)was statistically significant compared with Group C) at the24months (p<0.05). the pain relief effective rate (%) in Group A was91.4%(32/35)、94.26%(33/35)、94.26%(33/35)、85.70%(30/35)、82.86%(29/35)、80%(28/35) respectively at one month、two months、four months、eight months、 sixteen months、twentyfour months after the treatment. the pain relief effective rate (%) in Group B was84.21%(32/38)、89.47%(34/38)、86.84%(33/38)、78.94%(30/38).73.68%(28/38)、71%(27/38) respectively at one month、two months、four months、 eight months、sixteen months、twentyfour months after the treatment. the pain relief effective rate (%) in Group C was76.6%(23/30)、80%(24/30)、76.6%(23/30)、66.67%(20/30)、63.33%(19/30)、60%.(18/30); the hypesthesia rate was25.11%、26.32%、33.33%respectively at one month after the treatment, and with the time by,the hypesthesia symptom of most patients was relief in one year after operation, The hypesthesia rate was5.71%、7.89%、10%respectively when it was2years after operation.. there are2、4、6patients respectively in Group A、Group B and Group C whose pain have no change. Pain recurrence rate of three groups is17.14%、18.42%、20%respectively at24months after the treatment.Conclusion:Adriamycln interventional treatment on trigeminal neuralgia via foramen ovale under C arm X-ray machine and nerve stimulator dual guidance, The short-term and long-term therapeutic effects of adriamycin on trigeminal neuralgia is better in the group of the stimulating current is lower than0.1mA than the group of the stimulating current is stronger than0.4mA with no more significant adverse effects;When the stimulating current is lower than0.4mA,it can be the best therapeutic effect;The pain relief effective rate in three groups were not statistically significant,which confirm that adriamycin has a high degree of selective acting on the feeling of ganglion and can damage to the target cell which transmit pain fibers.