Subcutaneous sumatriptan for refractory trigeminal neuralgia
Subcutaneous sumatriptan for refractory trigeminal neuralgia
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DOI：
10.1111/j.1526-4610.2006.00405.x
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发表时间：
2006-04-01
期刊：
影响因子：
5
通讯作者：
Hoka, S
中科院分区：
文献类型：
--
作者：
Kanai, A;Saito, M;Hoka, S
背景。-三叉神经痛是指三叉神经根受到动脉的机械性压迫。5-HT 1B/1D受体激动剂可以抑制刺激的三叉神经根附近的神经源性炎症和血管舒张。研究5-HT 1B/1D受体激动剂舒马曲坦对三叉神经痛发作性疼痛的有效性。24例既往治疗无效的三叉神经痛患者随机接受皮下注射3 mg（1 mL）舒马曲坦或1 mL生理盐水安慰剂。7天后，患者交叉接受替代治疗。在治疗前和治疗后15分钟，用VAS评估触摸或移动面部引发的阵发性疼痛。患者使用描述性量表对疼痛分级结果进行评估，并要求记录疼痛是否复发以及治疗后多久复发。皮下注射舒马曲坦，而不是安慰剂，显著降低VAS从8.3 +/- 2.1至2.4 +/- 3.0 cm（平均值+/- SD）。舒马曲坦组中有20名患者描述他们的疼痛为中度或稍好，安慰剂组中有1名。皮下注射舒马曲坦的效果持续时间中位数为7.9小时（范围：1-20小时）。皮下注射舒马曲坦对既往治疗无效的三叉神经痛患者产生迅速的镇痛作用，且无严重不良反应。
Background.-Mechanical compression of the trigeminal root by an artery is thought to cause trigeminal neuralgia. The 5-HT1B/1D receptor agonist may inhibit neurogenic inflammation and vasodilation near the irritated trigeminal root.Objective.-To examine the effectiveness of a 5-HT1B/1D receptor agonist, sumatriptan, on a paroxysmal pain in trigeminal neuralgia.Methods.-Twenty-four patients with trigeminal neuralgia refractory to previous treatment were randomized to receive subcutaneously either 3 mg (1 mL) of sumatriptan or 1 mL of saline placebo. Following a 7-day period, patients crossed over to receive the alternative treatment. Paroxysmal pain triggered by touching or moving the face was assessed with VAS before and 15 minutes after the treatment. Patients used a descriptive scale to pain-grade outcome, and asked to note whether the pain returned and how long after therapy it recurred.Results.-Subcutaneous sumatriptan, but not placebo, significantly decreased VAS from 8.3 +/- 2.1 to 2.4 +/- 3.0 cm (mean +/- SD). The number of patients who described their pain as moderately or slightly better was 20 in the sumatriptan group and 1 in the placebo group. The effect of subcutaneous sumatriptan persisted for a median period of 7.9 hours (range: 1-20 hours).Conclusions.-Subcutaneous sumatriptan produced prompt analgesia without serious adverse reactions in patients with trigeminal neuralgia refractory to previous treatment.