Abstract：
Background: Trigeminal neuralgia is one of the most severe pain conditions that humans experience. Drug resistance is a challenging event during treatment that results in using higher doses of drugs or referring for neurosurgical treatment. Laser therapy is also an effective method for pain control. Objective: The aim of this study was to evaluate the effect of non-ablative non-thermal CO2 laser (NANTCL) on reducing pain in patients with drug-resistant trigeminal neuralgia (DRTN) for the very first time. Materials and methods: Twenty-four patients with DRTN were randomly divided into laser and placebo groups. Patients in the laser group received NANTCL (10,600 nm, 1.1 W, 100 HZ, 20 sec) on trigger points that were covered with lubricant gel 3 days in a week for 2 weeks. The placebo group received sham laser. The patients were requested to grade their pain on a visual analog scale (VAS) immediately, 1 week, 1 month, and 3 months after treatment. Results: In the laser group, the results revealed a significant decrease between the initial pain and the pain in all follow-up sessions. Only in three patients, 3 months after completion of laser therapy, pain returned to the initial level. In the control group, a significant difference was seen only between the pain of baseline and final session of laser irradiation. In laser group, the mean of pain (VAS) was lower than the placebo group in all follow-up sessions; however, it was only significant for 1 week after laser therapy. Conclusions: This study revealed that short-period application of NANTCL is effective for pain relief in patients with DRTN, especially those with extraoral trigger points. Clinical trial registration number: IRCT2013052113406N1.
摘要：
背景：三叉神经痛是人类经历的最严重的疼痛状况之一。耐药性是治疗期间的挑战性事件，导致使用更高剂量的药物或转诊为神经外科治疗。激光治疗也是控制疼痛的有效方法。目的：本研究的目的是首次评估非烧蚀非热CO2激光（NANTCL）减轻耐药三叉神经痛（DRTN）患者疼痛的效果。材料与方法:24例DRTN患者随机分为激光组和安慰剂组。激光组患者接受NANTCL（10,600nm，1.1W,100HZ,20秒）在每周3天覆盖有润滑剂凝胶的触发点上，持续2周。安慰剂组接受假激光。要求患者立即在视觉模拟量表（VAS）上对疼痛进行分级，1周,1个月,治疗后3个月。结果:激光组,结果显示,在所有随访期间,初始疼痛和疼痛之间均显著减少.只有三个病人，完成激光治疗后3个月，疼痛恢复到最初的水平。在对照组中，仅在基线疼痛和最后一次激光照射之间观察到显著差异.在激光组中，在所有随访中,平均疼痛(VAS)均低于安慰剂组;然而,仅在激光治疗后1周内有意义。结论：本研究表明，短期应用NANTCL可有效缓解DRTN患者的疼痛。尤其是那些有口外触发点的。临床试验注册号：IRCT2013052113406N1。
