Efficacy of botulinum toxin type A combined with ropivacaine in the treatment of trigeminal neuralgia

Objective To evaluate the clinical effect of botulinum toxin type A (BTX-A) combined with ropivacaine in the treatment of idiopathic trigeminal neuralgia. Methods Twenty patients with idiopathic trigeminal neuralgia who were treated at the Stomatological Hospital of China Medical University from December 2018 to October 2019 were selected and divided into experimental group and control group by random number table method. The experimental group was treated with BTX-A combined with ropivacaine, and the control group was treated with carbamazepine. The two groups were assessed with visual analog scores (VAS) before treatment and at the 1st hour, 6th hour, 12th hour, 1st week, 1st month, 3rd month and 6th month after treatment to compare the degree of pain, the frequency of pain onset and sleep quality to evaluate the efficacy. SPSS 20.0 was used for statistical analysis. Results The pain VAS scores of the experimental group were 0.4 ± 0.5 and 2.8 ± 3.1 at the 1st hour and the 1st month after treatment, respectively, which were lower than those in the control group (1.2 ± 1.0, 5.1 ± 1.4) , and the differences were statistically significant (t1st h=-2.191, P1st h= 0.047; t1st month=-2.155, P1st month= 0.045) ; The sleep quality scores of the experimental group at the 1st month after treatment were 7.8 ± 3.2, and the sleep quality scores of the control group were 10.8 ± 2.4. The sleep quality scores of the experimental group were lower than those of the control group at the 1st month after treatment, which was statistically significantly different (t=-2.395, P= 0.028) ; The frequency of pain onset of the experimental group was lower than that of the control group at the 1st week, 1st month and 3rd month after treatment, but higher than that of the control group at the 6th month after treatment, which was statistically significantly different (t1stweek=-2.900, P1st week=0.010; t1st month=-4.544, P1st month=0.001; t3rd month=-5.156, P3rd month=0.000; t6th month=3.391, P6th month= 0.003) . Conclusion BTX-A combined with ropivacaine can alleviate idiopathic trigeminal neuralgia and improve the quality of sleep of patients. Key words: Trigeminal neuralgia; Botulinum toxins, type A; Ropivacaine; Carbamazepine