• Jiayu Liu, Guangyong Wu, Yongan Jiang, Lei Li, Dongliang Wang, and Ruen Liu.
• Department of Neurosurgery, Peking University People's Hospital, Beijing, China.
• World Neurosurg. 2020 May 1; 137: e98-e105.

IntroductionChanges in blood pressure during trigeminal combing have been discussed in recent years. In this study, a retrospective analysis of patients with trigeminal neuralgia (TN) requiring microvascular decompression (MVD) with nerve combing was carried out to investigate fluctuation in arterial blood pressure during trigeminal nerve combing and its surgical effect and corresponding pathogenesis.MethodsA total of 70 cases of MVD with nerve combing performed during the treatment of primary TN patients were selected between January 2017 and January 2018 at Peking University People's Hospital. The degree of pain and prognosis of the patients were evaluated according to the visual analog scale. Postoperative facial numbness of the 2 groups were assessed by the Barrow Neurological Institute facial numbness score. Arterial blood pressure changes before and while combing the trigeminal nerve during MVD were dynamically monitored, and the patients were divided into responders and nonresponders. Total adrenaline (AD), norepinephrine (NE), and dopamine values were measured before and during trigeminal nerve combing.ResultsIncreased arterial blood pressure during the combing of the trigeminal nerve in MVD had a significant correlation with the prognosis of patients, with patients with higher arterial blood pressure having a better prognosis (P < 0.05). In the increased arterial blood pressure patients, precombing total AD and NE means were dramatically improved (P < 0.05).ConclusionsThis study shows that changes in arterial blood pressure during trigeminal nerve combing in MVD were correlated with the prognosis of patients. Further research is necessary to clarify the mechanism of increased arterial blood pressure.Copyright © 2020 Elsevier Inc. All rights reserved.

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