The First Affiliated Hospital of China Medical University, China.
Pain Physician. 2019 Jul;22(4):361-368.
Trigeminal postherpetic neuralgia is a severe neuropathic pain and often refractory to existing treatment, it develops secondary to herpes zoster-infected Gasserian ganglion. Therefore, it is important to prevent the transition of acute/subacute zoster-related pain to trigeminal postherpetic neuralgia. Despite numerous studies, the optimal intervention that reduces trigeminal postherpetic neuralgia incidence is still unknown.
This study aimed to evaluate the efficacy and safety of high-voltage, long-duration pulsed radiofrequency (PRF) on the Gasserian ganglion in patients with acute/subacute zoster-related trigeminal neuralgia.
Prospective, randomized, double-blinded study.
Department of Pain Medicine, the First Affiliated Hospital of China Medical University.
Ninety-six patients with acute/subacute zoster-related trigeminal neuralgia were equally randomly assigned into 2 groups. The electrode needle punctured the Gasserian ganglion guided by computed tomography in every patient. High-voltage, long-duration PRF at 42°C for 900 seconds was applied in the PRF group (n = 48). It was also applied in the sham group (n = 48) without radiofrequency energy output. The therapeutic effects were evaluated using a visual analog scale (VAS) and the 36-Item Short Form Health Survey (SF-36) at different time points. The average dosage of pregabalin (mg/d) administrated within the first month after treatment was also recorded.
The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group at different time points after treatment (P < 0.01). The SF-36 scores, which included physical functioning, physical role, bodily pain, general health perceptions, vitality, social function, emotional role, and the mental health index, were significantly improved at the sixth month after treatment in the PRF group compared with the sham group (P < 0.01). The average dosage of pregabalin administered (mg/d) within the first month after treatment was also significantly reduced in the PRF group compared with the sham group (P < 0.01). There were no bleeding, infection, or other severe side effects in both groups.
Single center study, relatively small number of patients.
High-voltage, long-duration PRF on the Gasserian ganglion is an effective and safe therapeutic alternative for patients with acute/subacute zoster-related trigeminal neuralgia.
Pulsed radiofrequency, zoster-related trigeminal neuralgia, visual analog scale, 36-Item Short Form Health Survey.
三叉神经疱疹后神经痛是一种严重的神经病理性疼痛，通常对现有治疗方法有抗性，它继发于带状疱疹感染的神经节。因此，预防急性/亚急性带状疱疹相关疼痛向三叉神经疱疹后神经痛的转变非常重要。尽管进行了大量研究，但降低三叉神经疱疹后神经痛发生率的最佳干预措施仍不清楚。
本研究旨在评估高电压、长时程脉冲射频（PRF）对急性/亚急性带状疱疹相关三叉神经痛患者的疗效和安全性。
前瞻性、随机、双盲研究。
中国医科大学附属第一医院疼痛医学科。
96 例急性/亚急性带状疱疹相关三叉神经痛患者被平均随机分为 2 组。在每位患者中，计算机断层扫描引导下将电极针穿刺至神经节。PRF 组（n = 48）给予 42°C 下 900 秒的高电压、长时程 PRF。假手术组（n = 48）也给予无射频能量输出的 PRF。在不同时间点使用视觉模拟量表（VAS）和 36 项简短健康调查（SF-36）评估治疗效果。还记录了治疗后第一个月内普瑞巴林（mg/d）的平均剂量。
治疗后不同时间点，PRF 组的术后 VAS 评分均明显低于假手术组（P < 0.01）。治疗后 6 个月，PRF 组的 SF-36 评分，包括身体机能、身体角色、躯体疼痛、总体健康感知、活力、社会功能、情感角色和心理健康指数，均明显高于假手术组（P < 0.01）。治疗后第一个月内，PRF 组普瑞巴林（mg/d）的平均剂量也明显低于假手术组（P < 0.01）。两组均无出血、感染或其他严重不良反应。
单中心研究，患者数量相对较少。
高电压、长时程 PRF 作用于神经节是治疗急性/亚急性带状疱疹相关三叉神经痛的有效且安全的治疗选择。
脉冲射频、带状疱疹相关三叉神经痛、视觉模拟量表、36 项简短健康调查。
