Application of Nalbuphine in Trigeminal Ganglion Pulse Radiofrequency Surgery in Patients with Postherpetic Neuralgia

Abstract

This study aimed to explore the application value of nalbuphine in pulsed radiofrequency operation of trigeminal ganglion in patients with postherpetic neuralgia (PHN). Thirty patients with PHN were randomly divided into the nalbuphine (Nalbu) group and ketorolac tromethamine (KT) group and received CT-guided pulsed radiofrequency surgery on trigeminal ganglion. The numeric rating scale (NRS) scores of patients were recorded at preoperative, intraoperative, and postoperative time points, before going to bed, and the next morning after the operation. In addition, the number of breakthrough pain before operation and within 24 hours after operation, the incidence of nausea and vomiting within 24 hours after surgery, and the patient’s sleep quality before and on the day after surgery were evaluated. The outcome data demonstrated that patients treated with nalbuphine had lower NRS scores after the pulse radiofrequency operation during and after the pulse radiofrequency operation compared to those with KT. In addition, nalbuphine effectively decreased the number of breakthrough pain, reduced the occurrence of nausea and vomiting after surgery, and improved the sleep quality. In conclusion, intramuscular injection of nalbuphine 30 min before trigeminal ganglion pulse radiofrequency surgery can be conducive to pain relief and improve the postoperative comfort of patients, providing an effective alternative for the alleviation of PHN in clinic.

Ozonated autohemotherapy combined with pulsed radiofrequency in the treatment of thoracic postherpetic neuralgia in older adults: a retrospective study

“…The affected neurons become inflamed and even necrosis, contributing to neuronal dysfunction, ectopic discharge, and peripheral and central sensitization. 22 , 23 Meanwhile, systemic inflammatory and immune imbalances 10 , 11 also participate in the process of PHN occurrence and development. Due to the complexity of PHN pathogenesis, monotherapy is not sufficient.…”

“…However, PHN is a chronic disease process. Its occurrence and development are accompanied by chronic inflammation and immune imbalances, 10 , 11 , 12 which are systemic responses. Consequently, simply relying on local analgesia is not sufficient.…”

Effectiveness and safety of high-voltage pulsed radiofrequency to treat patients with primary trigeminal neuralgia: a multicenter, randomized, double-blind, controlled study

“…In the past, radiofrequency treatment for TN patients was usually performed under C-arm fluoroscopic guidance which is associated with tissue injury caused by inaccurate puncture [ 23 , 40 , 41 ]. In this study, all patients underwent PRF treatment or nerve block under the guidance of 3D-CT which could ensure the puncture accuracy and prevent severe complications associated with inaccurate puncture such as carotid-cavernous fistula or cerebrospinal fluid leakage.…”