Microvascular decompression can effectively reduce arterial blood pressure in patients with Trigeminal Neuralgia

Clin Neurol Neurosurg. 2023 Oct:233:107945. doi: 10.1016/j.clineuro.2023.107945. Epub 2023 Aug 18.

Abstract

Background: Microvascular decompression (MVD) has been used in the treatment of Trigeminal Neuralgia (TN) and arterial hypertension (HTN). Results of several reports have supported its clinical effectiveness, however, little attention has been paid on arterial blood pressure changes caused by MVD in patients with TN.

Methods: In this single-center retrospective study, a cohort of 80 patients with TN who underwent MVD between 2021 and 2022 had been reviewed. Clinical data such as age, gender, pain duration, operation time, side and range of pain, HTN history, treatment history, VAS score, mean arterial pressure (MAP), and nausea or vomiting after operation were collected and analyzed via Linear regression to select possible related factors. Then, multiple linear regression of the possible predictors was used to identify the variables that significantly predicted MAP reduction.

Results: The VAS scores of TN patients after MVD surgery was significantly lower than that before operation, irrespective of the gender, side and range of pain, HTN history, RF history, and PONV (Wilcoxon test, P < 0.001). MVD can significantly decreased the blood pressure of TN patients, without interference from other factors. (MAP reduction ratio=14.46% ± 12.32%) (paired t-test, P < 0.001). The univariate and Multiple linear regression analysis showed that the preoperative MAP was significantly related to MAP reduction ratio (P < 0.001).

Conclusions: In patients with TN, MVD can significantly decrease arterial blood pressure. Blood pressure reductions were more prominent when cases with higher preoperative MAP.

Keywords: Blood pressure; Mean arterial pressure; Microvascular decompression; Predictor; Trigeminal Neuralgia.