Han Zhenkai, Hong Tao, Ding Yuanyuan, Wang Shimeng, Yao Peng
Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China.
Front Neurosci. 2020 Dec 18;14:579486. doi: 10.3389/fnins.2020.579486. eCollection 2020.
Postherpetic neuralgia (PHN) is a form of long-lasting neuropathic pain that can severely affect patients' quality of life. Pulsed radiofrequency (PRF) has been proven to be effective in treating PHN, but the optimal radiofrequency parameters are still not well defined. This retrospective study aimed to compare the efficacy and safety of CT-guided PRF at three different voltages for the treatment of PHN patients.
This study included 109 patients with PHN involving the thoracic dermatome who were treated in the Department of Pain Management of Shengjing Hospital, China Medical University, from January 2017 to May 2019. They were divided into three groups based on the PRF voltage used: group A (45 V), group B (55 V), and group C (65 V). The PRF therapy (voltage 45, 55, and 65 V) was performed in all patients by targeting the thoracic dorsal root ganglion. After surgery, patients were followed at 3 days, 1 month, 3 months, 6 months, and 12 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) scores, patient satisfaction, complications, and side effects.
Visual analog scale scores decreased and SF-36 scores increased for all patients in the three groups at each post-operative time point (1, 3, 6, and 12 months; all < 0.01). Pain relief, improvement in quality of life, and overall satisfaction were more significant for patients in group C than for those in groups A and B at the 3-, 6-, and 12-month follow-ups (all < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both < 0.01). A small number of patients from each group ( ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all > 0.05). At post-operative day 3, patients in group C had skin numbness affecting a larger area than patients in the other two groups (both < 0.05), but the differences were no longer statistically significant at day 30 after the operation. All patients experienced a drop in numbness area of more than 30% after surgery.
Compared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.
带状疱疹后神经痛（PHN）是一种持续时间较长的神经性疼痛，会严重影响患者的生活质量。脉冲射频（PRF）已被证明对治疗PHN有效，但最佳射频参数仍未明确界定。这项回顾性研究旨在比较CT引导下三种不同电压的PRF治疗PHN患者的疗效和安全性。
本研究纳入了2017年1月至2019年5月在中国医科大学附属盛京医院疼痛管理科接受治疗的109例累及胸段皮节的PHN患者。根据使用的PRF电压将他们分为三组：A组（45V）、B组（55V）和C组（65V）。所有患者均通过靶向胸段背根神经节进行PRF治疗（电压分别为45V、55V和65V）。术后，在3天、1个月、3个月、6个月和12个月对患者进行随访。每次随访的观察指标包括患者基本特征、视觉模拟评分（VAS）、36项简明健康调查量表（SF-36）评分、患者满意度、并发症和副作用。
三组患者在术后各时间点（1个月、3个月、6个月和12个月）的VAS评分均降低，SF-36评分均升高（均P<0.01）。在3个月、6个月和12个月的随访中，C组患者的疼痛缓解、生活质量改善及总体满意度均优于A组和B组患者（均P<0.05）。B组患者的VAS评分低于A组，总体满意度高于A组（均P<0.01）。每组均有少数患者（≤3例）出现轻度术中及术后并发症，与分组无关（均P>0.05）。术后第3天，C组患者皮肤麻木面积大于其他两组患者（均P<0.05），但术后第30天差异无统计学意义。所有患者术后麻木面积均下降超过30%。
与45V和55V的PRF相比，65V的PRF治疗PNH疗效更佳，安全性良好。
