Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs

Figures & data

Table 1 Baseline characteristics of the patients

	Protocol GBP+ROP (n = 17)	Protocol CBZ (n = 23)	Protocol MVD surgery (n = 22)
Age (years, average and SD)	63 (16.3)	66 (10.8)	66 (9.3)
Gender (women/total)	12/17	19/23	15/22
Pain location (trigeminal branches)
V1 or V2 or V3	7	13	6
V1 + V2 or V2 + V3	6	7	9
V1 + V2 + V3	4	3	7
Facial side (right/total)	12/17	10/23	11/22
Pain duration at day 0
1–5 years	13	9	4
6–10 years	4	5	14
≥11 years	0	9	4

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression.

Table 2 Average direct healthcare cost per patient

Protocol	Cost category	1st month (€)	2nd–6th month (€)*
GBP+ROP	GBP	7.29	109.2
	1st consultation	71.42
	Other consultations		205.1
	3 sessions	75.81
	Imaging tests	79.55
	Laboratory tests	18.40
	Total	252.47 (0)	314.3 (0)
CBZ	CBZ	9.9	49.9
	1st consultation	71.42
	Other consultations	205.10	205.1
	Imaging tests	79.55
	Laboratory tests	18.40
	Total	384.2 (1.5)	255.0 (6.3)
MVD	CBZ+GBP	30.39	49.6
	Surgery	719.90
	1st consultation	71.42
	Other consultations	137.12	205.1
	Imaging tests	79.55
	Laboratory tests
	Total	1056.78 (22.3)	254.7 (40.9)

* Notes: Sum of costs over 5 months (months 2–6); values in parentheses = standard deviation.

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression.

Figure 1 Effect of the three protocols (GBP+ROP, CBZ, and MVD) on the pain intensity of patients 6 months after day 0. For significant differences see the Results section.

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression; NRS, National Rating Scale.

Figure 2 Effect of the three protocols (GBP+ROP, CBZ, and MVD) on number of daily episodes of pain before (day 0) and after a 5-month follow-up (month 6). For significant differences see the Results section.

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression.

Figure 3 Effect of GBP+ROP, CBZ, and MVD protocols on the total SIP score of quality of life (A) and on the anxiety (B) and depression (C) scores measured by the HADS questionnaire. For significant differences see the Results section.

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression; HADS, Hospital Anxiety and Depression Scale; SIP, Sickness Impact Profile.

Figure 4 Satisfaction of patients submitted to GBP+ROP, CBZ, and MVD, for treatment (A) and the clinical team (B).

Abbreviations: GBP+ROP, gabapentin+ropivacaine; CBZ, carbamazepine; MVD, microvascular decompression.