Comparative Analysis of Efficacy and Safety of Trigeminal Ganglion Balloon Compression for Trigeminal Neuralgia Under Regional and General Anesthesia: A Retrospective Cohort Study.

BACKGROUND: Percutaneous balloon compression (PBC) is a surgical intervention for trigeminal neuralgia. This study hypothesized that PBC under regional anesthesia (RA) could reduce intraoperative hemodynamic fluctuations and postoperative adverse effects with efficacy equivalent to general anesthesia (GA). METHODS: In this retrospective cohort study, 159 patients who underwent PBC for trigeminal neuralgia at Xuanwu Hospital Capital Medical University between January 2022 and June 2023 were divided into RA (n = 60) and GA (n = 99) groups. Comparative analysis included intraoperative hemodynamics, postoperative efficacy, and adverse reactions over 12-month follow-up. RESULTS: Compared with GA, RA resulted in more stable intraoperative hemodynamics and significantly reduced trigeminocardiac reflex risk (P < 0.01). Patients had shorter operative duration; had reduced medical expenses; and experienced lower extent and faster recovery of postoperative numbness, hypoesthesia, and bite force decrease (P < 0.05). The groups were similar regarding pain scale decrease, oral analgesic reduction, patient satisfaction, and specific adverse events over 1-year follow-up (P > 0.05). CONCLUSIONS: PBC under RA has efficacy similar to GA without the need for GA management and resuscitation. RA was associated with more stable intraoperative hemodynamics and lower trigeminocardiac reflex incidence; reduced perioperative risk; enabled intraoperative communication with conscious patients, allowing for real-time assessment and adjustment of balloon compression extent, so that adverse events such as numbness were milder with faster recovery; resulted in shorter operative duration; and reduced medical expenses. This study demonstrated the clinical advantages and broad application prospects of PBC under RA, benefiting more patients with trigeminal neuralgia in remote areas.