Peripheral Nerve Stimulation Is Effective in the Management of Trigeminal Pain: A Systematic Review and meta-analysis.

INTRODUCTION

Trigeminal Neuralgia (TN) patients usually experience severe facial pain, leading to a significant reduction in quality of life.

OBJECTIVE

To evaluate the effect of peripheral nerve stimulation (PNS) on pain relief in patients with TN.

METHODS

The databases of EMBASE, WEB OF SCIENCE, and PUBMED were searched from inception to 2024 for clinical trials of PNS for TN. The inclusion criteria consisted of any study using PNS to treat TN and reporting outcomes of pain intensity. Risk of bias was assessed using Revised Cochrane Risk of Bias 2.0 and Methodological Index of Non-Randomised Studies (MINORS) tool. Meta-analysis was conducted with RevMan 5.3 and publication bias was evaluated via Egger's test through STATA17.

RESULTS

We identified 1,574 citations, and included 9 trials comprising 112 participants. In terms of efficacy, PNS was associated with significant pain relief compared to baseline (MD, -6.23 cm [95% CI, -7.20 to -5.26 cm], P < 0.05, I2 = 89%), with the reduction closely approaching the minimal important difference (MID) threshold of 6.25 cm. Subgroup analysis showed that patients with baseline pain scores ≥ 8 experienced greater pain relief (N = 52, MD, -7.06 cm [95% CI, -8.30 to -5.82 cm], I2 = 87%, p = 0.02) compared to patients with pain scores < 8(N = 60, MD, -4.75 cm [95% CI, -6.22 to -3.28 cm], I2 = 89%) .

CONCLUSIONS

The meta-analysis results showed PNS leads to a statistically and clinically significant improvement in pain. PNS may be a promising approach in the management of TN.