A systematic review of rescue analgesic strategies in acute exacerbations of primary trigeminal neuralgia  D. Moore, M.S. Chong, A. Shetty, J.M. Zakrzewska  British Journal of Anaesthesia  Volume 123, Issue 2, Pages e385-e396 (August 2019) DOI: 10.1016/j.bja.2019.05.026 Copyright © 2019 British Journal of Anaesthesia Terms and Conditions

Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram details the literature search. Of 452 potentially relevant studies, 17 studies investigated or referenced the efficacy of an analgesic therapy within 24 h of administration for trigeminal neuralgia. TN, trigeminal neuralgia. British Journal of Anaesthesia 2019 123, e385-e396DOI: (10.1016/j.bja.2019.05.026) Copyright © 2019 British Journal of Anaesthesia Terms and Conditions

Fig. 2 Risk of bias summary—review authors' judgements about each risk of bias item for the included RCTs. British Journal of Anaesthesia 2019 123, e385-e396DOI: (10.1016/j.bja.2019.05.026) Copyright © 2019 British Journal of Anaesthesia Terms and Conditions

Fig. 3 Evidence-based treatment algorithm for the management of acute exacerbations of trigeminal neuralgia. Management of acute exacerbations should proceed in parallel with a more definitive long-term management plan. The quality of evidence is included after each intervention. The moderate- and high-quality evidence receives a ‘should consider’ recommendation. The very low- and low-quality evidence are options that the clinician ‘may consider’ if interventions with higher quality evidence are contraindicated or not available. *Sumatriptan injection pens in the UK contain 6 mg in 1 ml, and we have recommended this for convenience as opposed to the 3 mg used by the Japanese group. †These concentrations may not be available in all countries (2–5% more common). TN, trigeminal neuralgia. British Journal of Anaesthesia 2019 123, e385-e396DOI: (10.1016/j.bja.2019.05.026) Copyright © 2019 British Journal of Anaesthesia Terms and Conditions