Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

Wen, Bixiu; Wang, Yajie; Zhang, Cong; Xu, Weicheng; Fu, Zhijian

doi:10.1177/0300060520977416

Cited by 12 publications

(9 citation statements)

References 36 publications

(81 reference statements)

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“…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).…”

Section: Discussionsupporting

confidence: 91%

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Yao

Han

et al. 2022

Front. Neurol.

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ObjectiveTo compare the effect, safety, and patient satisfaction of pulsed radiofrequency combined with methylene blue paravertebral nerve block and pulsed radiofrequency alone in the treatment of thoracic postherpetic neuralgia (PHN).MethodsA total of seventy-two patients with PHN diagnosed in the Department of Pain Management of Shengjing Hospital at China Medical University, from September 2019 to April 2021, were enrolled in the study. Patients were randomly divided into two groups. Group A (n = 36) received pulsed radiofrequency treatment. Group B (n = 36) received pulsed radiofrequency + methylene blue paravertebral nerve block. Patients were followed-up at 1 day, 1 week, 1 month, 3 months, and 6 months after treatment. Observation at each follow-up included basic patient characteristics, Visual Analog Scale (VAS), Hospital Anxiety and Depression Scale (HAD), the Insomnia Severity Index (ISI), patient satisfaction, complications, and side effects.ResultsCompared with preoperative values, the VAS scores significantly decreased in both groups at each postoperative time point (1 day, 1 week, and 1, 3, and 6 months; all p < 0.05). Compared with group A, VAS scores in group B were significantly lower 1 week and 1 month after surgery (p < 0.05). Patients in group B had lower HAD scores than those in group A 1 week after surgery (p < 0.05). Patients in group B had lower ISI scores than those in group A 1 day, 1 week, and 1, 3, and 6 months after surgery (p < 0.05). The pregabalin dosage in group B was lower than that in group A at 1 and 6 months after surgery (p < 0.05). Patient satisfaction was higher in group B than in group A at 1 week and 6 months after surgery (p < 0.05). There were no serious complications or side effects in either group.ConclusionPulsed radiofrequency combined with methylene blue paravertebral nerve block is superior to pulsed radiofrequency alone in the treatment of thoracic PHN, which can significantly relieve PHN and improve the condition of sleep and emotional disorders. Therefore, it is a safe and effective treatment method.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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

Yao

Han

et al. 2022

Front. Neurol.

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“…Surgical puncture and PRF may cause transient nerve edema and pain aggravation ( 35 ), and PRF treatment has a slower onset ( 2 ). Thus, the combined application of PRF and nerve block in this study will achieve better therapeutic effects ( 36 , 37 ).…”

Section: Discussionmentioning

confidence: 90%

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

Ding

Zhu

et al. 2021

Front. Neurol.

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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.

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“…Regular anti-neuropathic drug administration combined with interventional therapies is widely accepted in ZAP treatment. PRF is easily accepted as an appropriate intervention by both patients and physicians for its proven therapeutic effects, minimal invasiveness, and fewer adverse effects [ 8 ]. Although the mechanisms of PRF remain unclear, various researchers have been working toward revealing the underlying processes.…”

Section: Discussionmentioning

confidence: 99%

Development of a Model for Predicting the Effectiveness of Pulsed Radiofrequency on Zoster-Associated Pain

et al. 2022

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Introduction: Zoster-associated pain (ZAP), which may cause anxiety, depression, and sleep disorders and reduce quality of life, is often refractory to current standard treatments. Studies have shown that pulsed radiofrequency (PRF) can alleviate ZAP and reduce the incidence of postherpetic neuralgia (PHN). This study aimed to explore the clinical characteristics associated with PRF responsiveness, develop a model for identifying risk factors of inadequate PRF management, and help clinicians make better decisions. Methods: Patients who underwent PRF for ZAP between January 2017 and October 2020 in our hospital were included in this study. Patients were evaluated using the numerical rating scale (NRS), Insomnia Severity Index, Patient Health Questionnaire-9, and 36-Item Short Form Health Survey (SF-36) before and 3 months after the procedure. Patient demographic data and blood test results were also collected. We defined the effectiveness of PRF for ZAP as relief of [ 50% in NRS scores compared to pre-PRF. Least absolute shrinkage and selection operator (LASSO) regression analyses were subsequently performed to identify factors related to the therapeutic effect of PRF in patients with ZAP. The performance of the prediction model was assessed by the area under the receiver operating characteristic curve (AUC). Results: The effectiveness of PRF in patients with ZAP was 69.6% (total 313 patients) after 3 months. LASSO regression analysis extracted the seven most powerful features in the developed prediction model: sex, stage of herpes zoster (HZ), pregabalin dose, bodily pain indicators of SF-36, lymphocyte count, and low-density lipoprotein cholesterol (LDLC) and complement C4 in peripheral blood. Model = 1.586 ? 0.148 9 lymphocyte ? (-0.001) 9 bodily pain indicators of SF-36 ? (-0.001) 9 pregabalin dose ? 0.028 9 LDLC ? 0.001 9 C4 ? (-0.508) 9 sex ? (-0.128) 9 stage of HZ. We generated the ROC curve for the prediction model, and the final AUC was 0.701. The sensitivity, specificity, and overall accuracy of the model were 90%, 33%, and 73%, respectively. Conclusions: Seven factors were significantly associated with poor PRF outcome: male sex,

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Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis

Cited by 12 publications

References 36 publications

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

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

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

Development of a Model for Predicting the Effectiveness of Pulsed Radiofrequency on Zoster-Associated Pain

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