Journal of Dental Anesthesia and Pain Medicine

  • 제24권4호
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  • Pages.227-243
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  • 2024
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  • 2383-9309(pISSN)
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  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
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Factors associated with outcomes following microvascular decompression for the treatment of primary trigeminal neuralgia in adults: a systematic review and meta-analysis

  • Pablo Gomes-da Silva de Rosenzweig (Facultad de Ciencias de la Salud, Centro de Investigacion en Ciencias de la Salud (CICSA), Universidad Anahuac Mexico Norte Huixquilucan) ;
  • Santiago Pastrana-Brandes (Escuela de Medicina, Universidad Panamericana) ;
  • Salomon Merikansky-Gerson (Facultad de Ciencias de la Salud, Centro de Investigacion en Ciencias de la Salud (CICSA), Universidad Anahuac Mexico Norte Huixquilucan) ;
  • Luis Octavio Victoria-Garcia (Facultad de Ciencias de la Salud, Centro de Investigacion en Ciencias de la Salud (CICSA), Universidad Anahuac Mexico Norte Huixquilucan) ;
  • Magdalena Sophia Curtius-Caruso (Facultad de Ciencias de la Salud, Centro de Investigacion en Ciencias de la Salud (CICSA), Universidad Anahuac Mexico Norte Huixquilucan) ;
  • Jose Damian Carrillo-Ruiz (Coordinacion de Neurociencias, Facultad de Psicologia, Universidad Anahuac Mexico)
  • 투고 : 2024.06.04
  • 심사 : 2024.07.08
  • 발행 : 2024.08.01
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초록

This study aimed to evaluate pain assessment strategies and factors associated with outcomes after microvascular decompression for the treatment of primary trigeminal neuralgia in adults. We conducted a systematic review and meta-analysis of English, Spanish, and French literature. We searched three databases, PubMed, Ovid, and EBSCO, from 2010 to 2022 and selected studies including patients with primary trigeminal neuralgia, clear pain assessment, and pain outcomes. Population means and standard deviations were calculated. Studies that included factors associated with postoperative outcomes were included in the meta-analysis. A total of 995 studies involving 5673 patients with primary trigeminal neuralgia following microvascular decompression were included. Patients with arteries compressing the trigeminal nerve demonstrated optimal outcomes following microvascular decompression (odds ratio [OR]= 0.39; 95% confidence interval [CI] = 0.19-0.80; X2 = 46.31; Dof = 15; I2 = 68%; P = < 0.0001). Conversely, when comparing arterial vs venous compression of the trigeminal nerve (OR = 2.72; 95% CI = 1.16-6.38; X2 = 23.23; Dof = 10; I2 = 57%; P = 0.01), venous compression demonstrated poor outcomes after microvascular decompression. Additionally, when comparing single-vessel vs multiple-vessel compression (OR = 2.72; 95% CI = 1.18-6.25; X2 = 21.17; Dof = 9; I2 = 57%; P = 0.01), patients demonstrated unfavorable outcomes after microvascular decompression. This systematic review and meta-analysis evaluated factors associated with outcomes following microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). Although MVD is an optimal treatment strategy for PTN, a gap exists in interpreting the results when considering the lack of evidence for most pain assessment strategies.

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과제정보

1. We thank Dr. Jorge Moreno-Palacios and Dr. Rodolfo Rivas-Ruiz for their supervision of the statistical analysis. 2. Figure 1 was modified with text and annotation after adaptation of "Brain," "Brain Sections," and "Brainstem" from Servier Medical Art by Servier, licensed under a Creative Commons Attribution 3.0 Unported License" 3. Figure 2 was created using the R package and Shiny application (Haddaway, Page, Pritchard, & McGuinness, 2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams with interactivity for optimized digital transparency. Open Synthesis Campbell Systematic Reviews, 18, e1230. https://doi.org/10.1002/cl2.1230 4. Figure 3 was designed and created by Santiago Pastrana Brandes.

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