| Radiofrequency thermocoagulation for trigeminal neuralgia without intra-operative patient waking. | |
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MedLine Citation:
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PMID: 22483199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: It is proposed that radiofrequency thermocoagulation (RFT) under general anaesthesia without waking the patient intra-operatively, which is usually performed to confirm lesion location, will reduce the peri-operative discomfort and anxiety suffered by patients. METHODS: A retrospective review of all procedures, identified through standard hospital audit codes and performed by a single surgeon from 2000 to 2007. Postal questionnaires were sent to all eligible patients. Outcome criteria included pain relief, adverse events and patients' views on satisfaction, timing and outcomes. A Kaplan-Meier plot was used to determine actuarial rates of pain relief. RESULTS: Follow-up was available for 84% (37/44) of patients. Complete post-operative pain relief was 96% (42/44). The actuarial rates of complete pain relief at 6, 12, 24 and 36 months were 89%, 79%, 66% and 43%. No patients reported an outcome that did not meet their expectations while 71% (20/28) had an outcome that was better than their expectation. Serious complications included corneal numbness affecting 12% (5/41), but no cases of keratitis and a single case of anaesthesia dolorosa. CONCLUSIONS: Not waking a patient intra-operatively when performing a RFT is a viable treatment option that results in excellent early pain relief, comparable to results in the literature and without an increase in complications. Patient reported outcomes indicate a high rate of satisfaction and are a novel addition to our understanding of the procedure; there is no comparable data in the literature documenting patient satisfaction outcomes when the procedure is performed with patient waking. |
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Authors:
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Michael G Hart; Mark Nowell; Hugh B Coakham |
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Publication Detail:
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Type: Journal Article Date: 2012-04-07 |
Journal Detail:
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Title: British journal of neurosurgery Volume: 26 ISSN: 1360-046X ISO Abbreviation: Br J Neurosurg Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-05-29 Completed Date: 2012-08-22 Revised Date: 2013-01-15 |
Medline Journal Info:
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Nlm Unique ID: 8800054 Medline TA: Br J Neurosurg Country: England |
Other Details:
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Languages: eng Pagination: 392-6 Citation Subset: IM |
Affiliation:
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Academic Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrookes Hospital, Cambridge, UK. m.g.hart@doctors.net.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Anesthesia, General Electrocoagulation / methods* Female Humans Intraoperative Care / methods Male Middle Aged Pain Measurement Pain, Postoperative / prevention & control Patient Satisfaction Quality of Life Questionnaires Radiosurgery / methods* Recurrence Treatment Outcome Trigeminal Neuralgia / surgery* Wakefulness |
| Comments/Corrections | |
Comment In:
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Br J Neurosurg. 2012 Dec;26(6):932; author reply 933
[PMID:
22967114
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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