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Research ArticleOriginal Article
Open Access

Efficacy of bupivacaine injection after pulsed radiofrequency ablation in the management of trigeminal facial pain

A prospective, randomized, and double-blind study

Faisal M. Hilal, Omar A. Alyamani and Abdullah M. Kaki
Saudi Medical Journal June 2022, 43 (6) 551-558; DOI: https://doi.org/10.15537/smj.2022.43.6.20220089
Faisal M. Hilal
From the Department of Anesthesia (Hilal), King Fahad General Hospital, and from the Department of Anesthesia and Critical Care (Alyamani, Kaki), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MBBS, SBA
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Omar A. Alyamani
From the Department of Anesthesia (Hilal), King Fahad General Hospital, and from the Department of Anesthesia and Critical Care (Alyamani, Kaki), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MBBS, D.ABA
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Abdullah M. Kaki
From the Department of Anesthesia (Hilal), King Fahad General Hospital, and from the Department of Anesthesia and Critical Care (Alyamani, Kaki), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MBChB, MD.
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  • For correspondence: [email protected]
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Consolidated standards of reporting trials (CONSORT) diagram of the trial showing the process of patient enrollment and study flow.

  • Figure 2
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    Figure 2

    - Kaplan-Meyer analysis of the duration of pain relief.

  • Figure 3
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    Figure 3

    - The alteration in the dose of medications post-procedure according to the study subjects. Percentage: indicates the use of pain medications after the procedure among the study subjects

Tables

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    Table 1

    - Characteristics pertaining to the patients in both groups.

    VariablesGroup I (n=39)Group II (n=34)Total (N=73)
    #x00A0;Mean±SD
    Age57.33±13.7265.91±10.80561.33±13.093
    Height (cm)158.49±16.604154.91±8.487156.82±13.481
    Weight (kg)73.497±18.279962.224±18.879768.247±19.282
    Gender
    Male16 (41.0)10 (29.4)26 (35.6)
    Female23 (59.0)24 (70.6)47 (64.4)
    Nationality
    Saudi34 (87.2)28 (82.4)62 (84.9)
    Non-Saudi5 (12.8)6 (17.6)11 (15.1)
    Smoker
    Yes2 (5.1)4 (11.8)6 (8.2)
    No34 (87.2)25 (73.5)59 (80.8)
    Ex-smoker3 (7.7)5 (14.7)8 (11.0)
    History
    DM14 (35.9)10 (29.4)24 (32.9)
    HTN21 (53.8)16 (47.1)37 (50.7)
    IHD12 (30.8)7 (20.6)19 (26.0)
    Psychiatric disorders9 (23.1)10 (29.4)19 (26.0)
    Dental procedures18 (46.2)24 (70.6)42 (57.5)

    Data are presented as a number and precentage (%). DM: diabetes mellitus, HTN: hypertension, IHD: ischemic heart disease, SD: standard deviation

      • View popup
      Table 2

      - The features of pain pertaining to all the subjects.

      VariablesGroup I (n=39)Group II (n=34)Total (n=73)P-value
      Trigeminal type
      Neuropathic34 (87.2)32 (94.1)66 (90.4)0.315
      Neuralgia5 (12.8)2 (5.9)7 (9.6)
      Side
      Right26 (66.7)13 (38.2)39 (53.4)0.015
      Left13 (33.3)21 (61.8)34 (46.6)
      Branch affected
      V12 (5.1)-2 (2.7)0.112
      V29 (23.1)17 (50.0)26 (35.6)
      V37 (17.9)5 (14.7)12 (16.4)
      V1, V2, and V31 (2.6)-1 (1.4)
      V2, V320 (51.3)12 (35.3)32 (43.8)
      Pre-procedure score on the numerical rating scale#x00A0;#x00A0;#x00A0;#x00A0;
      66 (15.4)2 (5.9)8 (11.0)0.075
      713 (33.3)20 (58.8)33 (45.2)
      814 (35.9)12 (35.3)26 (35.6)
      96 (15.4)#x00A0;6 (8.2)
      Post-procedure score on the numerical rating scale#x00A0;#x00A0;#x00A0;#x00A0;
      00 (0.0)1 (2.9)1 (1.4)0.709
      113 (33.3)10 (29.4)23 (31.5)
      214 (35.9)13 (38.2)27 (37.0)
      311 (28.2)10 (29.4)21 (28.8)
      41 (2.6)0 (0.0)1 (1.4)

      Data are presented as a number and precentage (%). V1: ophthalmic branch, V2: maxillary branch, V3: mandibular branch

        • View popup
        Table 3

        - The binary logistic regression analysis to identify the predictors associated with the reduction in dosage of medications.

        VariablesBS.E.WalddfSig.Exp (B)
        Local anaesthetic agent2.0510.8316.08710.0147.778
        Constant0.5880.3942.22110.1361.800

        Variables excluded from the final model: age, gender, body mass index, diabetes mellitus, hypertension, ischemic heart disease, and smoking. B: regression coefficients, S.E.: standard error around the coefficient for the constant, Wald: Wald Chi-square test statistic, df: degree of freedom, Sig.: p-value of Wald test at <0.05 indicates significant result, Exp (B): expected beta

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        Saudi Medical Journal: 43 (6)
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        1 Jun 2022
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        Efficacy of bupivacaine injection after pulsed radiofrequency ablation in the management of trigeminal facial pain
        Faisal M. Hilal, Omar A. Alyamani, Abdullah M. Kaki
        Saudi Medical Journal Jun 2022, 43 (6) 551-558; DOI: 10.15537/smj.2022.43.6.20220089

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        Efficacy of bupivacaine injection after pulsed radiofrequency ablation in the management of trigeminal facial pain
        Faisal M. Hilal, Omar A. Alyamani, Abdullah M. Kaki
        Saudi Medical Journal Jun 2022, 43 (6) 551-558; DOI: 10.15537/smj.2022.43.6.20220089
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        Keywords

        • trigeminal neuralgia
        • trigeminal neuropathic pain
        • atypical facial pain
        • bupivacaine
        • pulsed radiofrequency
        • facial pain

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