Cardiovascular response during trigeminal ganglion compression for trigeminal neuralgia according to the use of local anesthetics.
OBJECTIVE
There are controversies about the use of local anesthetics during balloon compression for trigeminal neuralgia (TN) as a protective factor for cardiovascular events. The objective of this study was to investigate cardiovascular parameters (blood pressure and heart rate [HR]) of patients that underwent trigeminal balloon compression with local anesthetics compared to a control group (placebo).


METHODS
This is a randomized controlled study; 55 patients were randomized into two groups: study (deep sedation and trigeminal block with 0.8-mL lidocaine 2%) and control group (deep sedation and trigeminal injection of 0.8-mL saline). Blood pressure and HR were measured in five distinct moments: preoperative, during puncture for local anesthesia/placebo, during puncture with the catheter, during balloon compression, and final evaluation. Statistical analysis was performed with Pearson's chi (2) and McNemar tests and the analysis of variance for repetitive measures.


RESULTS
The means of systolic and diastolic blood pressures (SBP and DBP, respectively) were higher in the control group when compared to the study group at the evaluation during puncture with the catheter (p < 0.001) and balloon compression (p < 0.001 and p = 0.018 for DBP and SBP, respectively). There was an increase in the HR in the control group during the procedure (p = 0.017).


CONCLUSIONS
The use of local anesthetics during the trigeminal balloon compression for TN can have a preventive role for the risk of cardiovascular events.
Tibano
Adriana Tanaka
AT
Neurology Department, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
de Siqueira
Silvia Regina D T
SR
da Nóbrega
José Cláudio Marinho
JC
Teixeira
Manoel Jacobsen
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects*; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D012668:Trigeminal Ganglion / Q000473:pathology / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000473:pathology / Q000601:surgery*
D000779:Anesthetics, Local