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Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia
Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patient...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Japan Neurosurgical Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325773/ https://www.ncbi.nlm.nih.gov/pubmed/37019653 http://dx.doi.org/10.2176/jns-nmc.2022-0288 |
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author | OTSU, Yusuke KAJIWARA, Sosho HASHIMOTO, Aya SAKATA, Kiyohiko NEGOTO, Tetsuya HASEGAWA, Yu NAKAMURA, Hideo HIROHATA, Masaru MORIOKA, Motohiro |
author_facet | OTSU, Yusuke KAJIWARA, Sosho HASHIMOTO, Aya SAKATA, Kiyohiko NEGOTO, Tetsuya HASEGAWA, Yu NAKAMURA, Hideo HIROHATA, Masaru MORIOKA, Motohiro |
author_sort | OTSU, Yusuke |
collection | PubMed |
description | Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable. |
format | Online Article Text |
id | pubmed-10325773 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-103257732023-07-07 Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia OTSU, Yusuke KAJIWARA, Sosho HASHIMOTO, Aya SAKATA, Kiyohiko NEGOTO, Tetsuya HASEGAWA, Yu NAKAMURA, Hideo HIROHATA, Masaru MORIOKA, Motohiro Neurol Med Chir (Tokyo) Original Article Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable. The Japan Neurosurgical Society 2023-04-06 /pmc/articles/PMC10325773/ /pubmed/37019653 http://dx.doi.org/10.2176/jns-nmc.2022-0288 Text en © 2023 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License. |
spellingShingle | Original Article OTSU, Yusuke KAJIWARA, Sosho HASHIMOTO, Aya SAKATA, Kiyohiko NEGOTO, Tetsuya HASEGAWA, Yu NAKAMURA, Hideo HIROHATA, Masaru MORIOKA, Motohiro Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title | Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title_full | Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title_fullStr | Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title_full_unstemmed | Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title_short | Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia |
title_sort | effects of microvascular decompression on pain relief and quality of life in late elderly patients with trigeminal neuralgia |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325773/ https://www.ncbi.nlm.nih.gov/pubmed/37019653 http://dx.doi.org/10.2176/jns-nmc.2022-0288 |
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