Effective Treatment of Postherpetic Neuralgia at the First Branch of the Trigeminal Nerve by High-Voltage Pulsed Radiofrequency

Abstract

Background: Postherpetic neuralgia (PHN) is one of the most common and serious complications of herpes zoster. PHN of the first branch of the trigeminal nerve is painful and difficult to treat, as no definitive effective treatment is available. The aim of this retrospective study was to observe the efficacy and safety of treatment of PHN of the first branch of the trigeminal nerve with high-voltage pulsed radiofrequency (PRF) of the supraorbital nerve.Methods: Fifty-two patients diagnosed with the PHN of the first branch of the trigeminal nerve at the Department of Pain Management, Shengjing Hospital, China Medical University, between April 2017 and October 2020 were selected. The PRF treatment of the supraorbital nerve was used. The patients were divided into two groups according to the treatment received: group C, conventional PRF group; and group H, high-voltage PRF group. The basic conditions, pain scores, and SF-36 scores of patients before treatment were recorded. Also, intraoperative and postoperative adverse events, visual analog scale (VAS) scores, 36-Item Short Form Health Survey (SF-36) scores at 1 week, 1 month, 3 months, and 6 months of follow-up were recorded. Furthermore, treatment efficiency was followed up at 6 months after treatment.Results: The VAS scores of patients in both groups were significantly lower at all time points after treatment compared with presurgery. VAS scores in group H were lower than those in group C 1, 3, and 6 months after treatment. SF36 scores of patients in group H were better than those in group C 1, 3, and 6 months after treatment. The treatment efficiency at 6 months after treatment was higher in group H than in group C. No serious adverse events occurred in both groups.Conclusion: The efficacy of the high-voltage PRF of the supraorbital nerve in treating the PHN of the first branch of the trigeminal nerve was superior to that of conventional PRF. It was a safe and effective treatment method.

Pulsed Radiofrequency Combined With Methylene Blue Paravertebral Nerve Block Effectively Treats Thoracic Postherpetic Neuralgia

“…This allows PRF to ease PHN without changing the nerve fiber structure (23,24). In this study, pain was relieved after PRF therapy, which is consistent with the findings of previous studies (10)(11)(12)(13). However, other studies reported that PRF therapy efficacy in treating PHN was not ideal (14,15).…”

“…However, there are different opinions about the effectiveness of PRF therapy for PHN. Some reports believe that PRF can effectively relieve pain and improve the quality of life of patients with PHN (10)(11)(12)(13). Other reports suggest that PRF is not the ideal therapy for treating neuropathic pain (14) and that PRF does not significantly relieve nerve root pain (15).…”

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

“…Here, we used PRF technique to precisely intervene in the function of DRG. PRF had been proven to be an effective technique for pain management [ 10 – 12 , 20 – 22 ]. PRF technique generates a high-voltage but low-temperature (<40°C) environment around target nerve through high-frequency pulsed current, which can affect the conduction of pain sensory [ 23 ].…”

Efficacy and Safety of High-Voltage Pulsed Radiofrequency versus Standard-Voltage Pulsed Radiofrequency for Patients with Neuropathic Pain: A Literature Review and Meta-Analysis

“…A total of 28 studies remained for full-text screening. Finally, 6 studies [20][21][22][27][28][29] with 423 patients were included for data extraction and final analysis (Figure 1).…”