Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2026 Jan 28;51(1):22-30. doi: 10.11817/j.issn.1672-7347.2026.250479.
ABSTRACT
OBJECTIVES: Pulsed radiofrequency (PRF) treatment of the trigeminal ganglion via foramen ovale puncture for zoster-associated trigeminal neuralgia typically requires patient feedback during sensory and motor stimulation, and is usually performed under regional anesthesia (RA). However, under RA, patients often experience poor comfort due to pain and anxiety during puncture and PRF, and severe pain occurs when adjusting needle position or increasing output voltage. This often leads to lower-than-optimal treatment voltages, poor patient cooperation, and sometimes interruption or refusal of treatment. The Department of Anesthesiology at Xiangya Hospital, Central South University, has performed CT-guided trigeminal ganglion PRF under general anesthesia (GA) for zoster-associated trigeminal neuralgia. Currently, no studies directly compare the efficacy and safety of GA versus RA for this procedure. This study aims to compare GA and RA in terms of safety and efficacy for trigeminal ganglion PRF treatment of zoster-associated trigeminal neuralgia, providing clinical guidance for optimal anesthesia choice.
METHODS: Data were retrospectively collected for hospitalized and treated with trigeminal ganglion PRF for zoster-associated trigeminal neuralgia at Xiangya Hospital, Central South University, from July 2022 to January 2025. Patients were grouped according to the anesthesia method used during PRF: GA group and RA group. Baseline characteristics (demographics, comorbidities, disease features) were compared between groups. Pain was assessed using the Visual Analogue Scale (VAS) at 1 day, 1 month, 3 months, and 6 months postoperatively, and changes from baseline were analyzed. Patient satisfaction, total hospitalization duration, direct medical costs, and perioperative complications (hypertension, hypotension, bradycardia, tachycardia, etc.) were also compared.
RESULTS: A total of 61 patients were included (GA group, n=29; RA group, n=32). Baseline characteristics were comparable between groups (all P>0.05). Two-way repeated measures analysis of variance showed a significant main effect of time [F(4, 295)=2 181, P<0.001], no significant main effect of group [F(1, 295)=1.377, P=0.241 5], and a significant interaction effect [F(4, 295)=4.821, P<0.001]. VAS scores at 1 day, 1 month, 3 months, and 6 months postoperatively were significantly lower than preoperative values in both groups (all P<0.05); differences between groups at all time points were not statistically significant (all P>0.05). Median hospitalization costs were 16 602 (14 904, 17 988) CNY for the GA group and 12 719 (8 709, 13 876) CNY for the RA group, with a significant difference (P<0.001). Median hospital stay was 6 (5, 7) days for both groups (P=0.606). Incidences of hypertension and tachycardia were significantly higher in the RA group than the GA group (both P<0.05). Other complications (facial swelling, dizziness, nausea, vomiting) did not differ significantly (all P>0.05). Patient satisfaction was higher in the GA group than the RA group (82.76% vs 56.25%, P=0.031).
CONCLUSIONS: GA and RA provide comparable efficacy for trigeminal ganglion PRF in zoster-associated trigeminal neuralgia. However, GA significantly improves patient satisfaction and reduces cardiovascular stress without increasing other postoperative complications. PRF under GA is safe and feasible.
PMID:42032956 | DOI:10.11817/j.issn.1672-7347.2026.250479