Comparison of the efficacy of radiofrequency ablation at 60°C, 65°C and 70°C for managing trigeminal neuralgia

  • Trianggoro Budisulistyo
  • Amin Husni
  • Dwi Pudjonarko
Keywords: trigeminal neuralgia, radiofrequency ablation, electrode placement, temperature, neuropathic pain, LANSS

Abstract

Introduction: The observed efficacy of radiofrequency ablation (RFA) in patients with trigeminal neuralgia (TN) ranged from 42.2% to 97.2% at 2 to 15 years' follow-up. The temperature used varied from 60°C to 95°C, with nonsignificant differences for durations of 2 min or more. Here we compare the analgesic efficacy of 60°C, 65°C and 70°C for a single 90-sec duration.

Methodology: The study was conducted in 100 patients (57 females, 43 males), at Dr Kariadi Hospital Semarang, using the Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) in patients with trigeminal neuralgia. They were divided into control and three RFA groups, e.g., 60°C, 65°C, and 70°C. Carbamazepine 100-200 mg every 8-12 hours and vitamin B12 50 µg every 12 hours, were administered in the control group. While RFA was applied in three RFA groups by placing the electrode needle as close to the target branch(es) at prescribed temperatures for 90 sec duration. Follow-up was done pre-intervention, at 2 weeks, 3 months and 6 months.

Results: All one hundred patients included showed significant improvement in pain (P < 0.001). The RFA groups showed significant improvement compared to the control group (P < 0.05). Comparison by RFA 60°C group was not significant (P = 0.083) at 3- and 6-months follow-up, but it was significant in RFA 65°C group (P < 0.001). Comparison between RFA 60°C and RFA 65°C groups was not significant.

Conclusions: RFA 60°C has similar efficacy results to 65°C or 70°C in the treatment of trigeminal neuralgia patients and may cause less tissue damage. Needle placement to the nearest affected branch(es) was more important than temperature of RFA procedures.                                                  

Abbreviations: TN: trigeminal neuralgia, SCA: superior cerebellar artery, MVD: microvascular decompression, RTC: radiofrequency thermocoagulation, RFA: radiofrquency ablation, EMF: electromagnetic field, PRF: pulsed radiofrequency, NRS: numerical rating scale, GABA: gamma-aminobutyric acid

Keywords: trigeminal neuralgia; radiofrequency ablation: electrode placement: temperature: neuropathic pain; LANSS

Citation: Budisulistyo T, Husni A, Pudjonarko D. Comparison of the efficacy of radiofrequency ablation at 60°C, 65°C and 70°C for managing trigeminal neuralgia. Anaesth. pain intensive care 2025;29(1):03-08. DOI: 10.35975/apic.v29i1.2662

Received: May 09, 2024; Reviewed: October 26, 2024; Accepted: January 01, 2025

Published
01-31-2025
How to Cite
Budisulistyo, T., Husni, A., & Pudjonarko, D. (2025). Comparison of the efficacy of radiofrequency ablation at 60°C, 65°C and 70°C for managing trigeminal neuralgia. Anaesthesia, Pain & Intensive Care, 29(1), 3-8. https://doi.org/10.35975/apic.v29i1.2662
Section
ORIGINAL RESEARCH

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