Efficacy of High-Voltage Pulsed Radiofrequency for the Treatment of Elderly Patients with Acute Herpes Zoster Neuralgia

Wang, Bo; Du, Zhongju; Xia, Jurong; Zhang, Hua

doi:10.1590/1806-9282.20201124

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…21 On the contrary, recent studies have shown that PRF effectively controls HZ-related pain. Wang et al 15 showed that high-voltage pulsed radiofrequency can relieve pain, improve sleep quality, reduce the doses of anticonvulsants and analgesics, and decrease the incidence of clinically meaningful PHN. Fei et al 22 confirmed that PRF combined with paravertebral injection of recombinant human interferon-α2b was an effective treatment for acute stage herpes zoster neuralgia.…”

Section: Discussionmentioning

confidence: 99%

“…High-voltage and long-duration PRF can reduce pain degree and improve the quality of life. 14,15 But, the voltage of PRF depends on the patient's tolerance. Not all patients were suitable for high-voltage and long-duration PRF.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, increasing evidence suggests that the voltage and the cycles were related to the therapeutic effect of PRF. High‐voltage and long‐duration PRF can reduce pain degree and improve the quality of life 14,15 . But, the voltage of PRF depends on the patient's tolerance.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain

Feng

2023

CNS Neurosci Ther

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Background Herpes zoster (HZ)‐related pain, characterized by chronic and persistent pain with a dermatomal distribution, is a relatively common complication of HZ. Pulsed radiofrequency (PRF) can effectively relieve HZ‐related pain. There is no study on the effect of the needle tip position in patients with HZ for PRF treatment. This prospective study was conducted to compare two distinct needle tip positions in PRF for HZ‐related pain. Methods Seventy‐one patients suffering from HZ‐related pain were enrolled in this study. According to the dorsal root ganglion (DRG) position and needle tip position, patients were randomly allocated to the IP group (group inside of the pedicle, n = 36) and OP group (group outside of the pedicle, n = 35). Quality of life and pain control were evaluated with the visual analog scale (VAS) and activities of daily living questionnaires (including 7 items: general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life), which were administered before therapy and at intervals of 1, 7, 30, and 90 days after therapy. Results Before therapy, the mean pain score was found to be 6.03 ± 0.45 in the IP group and 6.00 ± 0.65 in the OP group (p = 0.555). No significant differences were found when the two groups were compared at 1 and 7 days after therapy (p > 0.05). But, the pain score was significantly lower in the IP group at 30 days (1.78 ± 1.31 vs. 2.77 ± 1.31, p = 0.006) and 90 days of follow‐up (1.29 ± 1.19 vs. 2.15 ± 1.74, p = 0.041). Significant differences between the two groups in terms of general activity (2.39 ± 0.87 vs. 2.86 ± 0.77, p = 0.035), mood (1.97 ± 1.65 vs. 2.86 ± 1.50, p = 0.021), relations with other people (1.94 ± 0.92 vs. 2.51 ± 1.22, p = 0.037), sleep (1.64 ± 1.44 vs. 2.97 ± 1.44, p < 0.001), and enjoyment of life (1.58 ± 1.11 vs. 2.43 ± 1.33, p = 0.004) were detected after the 30‐day follow‐up. In addition, scores for the activities of daily living were significantly lower in the IP group than that in the OP group at 90 days after therapy (p < 0.05). Conclusion The needle tip position had an influence on the PRF treatment in patients with HZ‐related pain. Positioning the needle tip in the area between the medial and lateral edges of adjacent pedicles offered good pain relief and improved quality of life in HZ patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain

Feng

2023

CNS Neurosci Ther

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“…The results showed that 30 of 32 patients (93.75%) had significant pain relief after PRF, and 28 of 32 patients (87.5%) were satisfied with their sleep [5]. For elderly PHN, high-voltage PRF can quickly and smoothly reduce the degree of pain, improve sleep quality, reduce the amount of anticonvulsant drugs and analgesics, and reduce its incidence [6]. Therefore, PRF can safely and effectively improve the clinical symptoms of PHN patients from neck to lumbosacral region, improve the quality of life of patients, and can be further promoted in clinical practice.…”

Section: Postherpetic Neuralgiamentioning

confidence: 98%

Progress in Clinical Application of Pulsed Radiofrequency for Chronic Pain

2023

JCMP

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Chronic pain is one of the health problems of common concern around the world. With the increasing expectation of patients for the therapeutic effect, traditional drug therapy has been difficult to meet the needs of patients. As a new minimally invasive pain treatment technology, pulsed radiofrequency has significant clinical effect, simple operation and repeatability, and plays an important role in the treatment of chronic pain. This article reviews the application of pulsed radiofrequency in the treatment of various chronic pain, in order to provide reference for clinical treatment.

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“…After decades of research on PHZ, its exact neuropathological mechanisms are still not well understood [ 3 ]. Currently, effective treatments for PHZ mainly include oral analgesics, pulsed radiofrequency (PRF), and spinal cord stimulation (SCS) [ 1 , 7 – 9 ]. For elderly patients with intractable PHN, oral drugs always fail to achieve complete pain relief and produce side effects as the drugs dose increases.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Spinal Cord Stimulation or Pulsed Radiofrequency for Elderly Patients with Postherpetic Neuralgia: A Prospective Randomized Controlled Trial

et al. 2022

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Background. Postherpetic neuralgia (PHN) is the most common and severe complication after varicella-zoster infection, especially in elderly patients. PHN is always refractory to treatment. Both pulsed radiofrequency (PRF) and short-term spinal cord stimulation (stSCS) have been used as effective analgesia methods in clinic. However, which technique could provide better pain relief remains unknown. Objectives. This study is aimed at evaluating the efficacy and safety of PRF and stSCS in elderly patients with PHN. Study Design. A prospective, randomized-controlled study. Setting. Department of Pain Management, the Second Affiliated Hospital of Guangzhou Medical University. Methods. A total of 70 elderly patients with PHN were equally randomized to the PRF group or stSCS group. Patients in the PRF group received PRF treatment, while patients in the stSCS group received stSCS treatment. The primary outcome was the effective rate. The secondary outcomes included the Visual Analogue Scale (VAS), the 36-Item Short Form Health Survey Questionnaire (SF-36), and the pregabalin dosage. All outcomes were evaluated at baseline and at different postoperative time points. Results. At 12 months after surgery, the effective rate reached 79.3% in stSCS group, while 42.1% in PRF group. The effective rate was significantly higher in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. VAS scores decreased significantly at each postoperative time point in both groups ( P < 0.001 ). The VAS scores were significantly lower in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. SF-36 scores (bodily pain and the physical role) were significantly improved at each postoperative time point in both groups ( P < 0.001 ). The SF-36 scores were significantly higher in the stSCS group than in the PRF group at some postoperative time points. The pregabalin dosage was significantly lower in the stSCS group than in the PRF group at 3, 6, and 12 months after surgery. Limitations. A single-center study with a relatively small sample size. Conclusions. Both PRF and stSCS are effective and safe neuromodulation techniques for elderly patients with PHN. However, stSCS could provide better and longer-lasting analgesic effect compared to PRF.

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Efficacy of High-Voltage Pulsed Radiofrequency for the Treatment of Elderly Patients with Acute Herpes Zoster Neuralgia

Cited by 8 publications

References 13 publications

Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain

Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain

Progress in Clinical Application of Pulsed Radiofrequency for Chronic Pain

Short-Term Spinal Cord Stimulation or Pulsed Radiofrequency for Elderly Patients with Postherpetic Neuralgia: A Prospective Randomized Controlled Trial

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