Department of Pain Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Department of Emergency Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China.
Pain Res Manag. 2024 Sep 19;2024:1992483. doi: 10.1155/2024/1992483. eCollection 2024.
Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)-related trigeminal neuralgia and prevent the further development of TPHN. High-voltage, long-duration pulsed radiofrequency (HL-PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti-inflammatory effects and potential analgesic benefits. We included 83 patients with HZ-related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL-PRF combined with block. A 6-month follow-up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events. All patients showed a significant decrease in postoperative NRS scores ( < 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points ( < 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group (=0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference (=0.047). The PSQI score of the acute group was consistently lower than that of the subacute group ( < 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group ( < 0.01). All patients did not experience serious adverse reactions. Gasserian ganglion HL-PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster-related trigeminal neuralgia and prevent the incidence of TPHN.
三叉神经带状疱疹后神经痛（TPHN）是一种严重的慢性疼痛，可导致各种社会经济后果。因此，有必要探索治疗急性/亚急性带状疱疹相关三叉神经痛的最佳治疗方案，并预防 TPHN 的进一步发展。高电压、长时间脉冲射频（HL-PRF）的三叉神经节是一种新的手术干预手段，用于治疗 PHN。已有报道称神经节阻滞具有抗炎作用和潜在的镇痛益处。
我们纳入了 2021 年 1 月 1 日至 2023 年 6 月 1 日收治的 83 例带状疱疹相关急性/亚急性三叉神经痛患者，均接受 Gasserian 神经节 HL-PRF 联合阻滞治疗。进行了 6 个月的随访，包括数字评分量表（NRS）评分、匹兹堡睡眠质量指数（PSQI）、TPHN 的发生率、抗惊厥药和镇痛药的剂量、疗效和不良反应。
所有患者术后 NRS 评分均明显下降（<0.05）。急性带状疱疹组的 NRS 评分在不同时间点均明显低于亚急性带状疱疹组（<0.01）。从带状疱疹发病到 12 周时，TPHN 的总发生率为 21.68%。急性期组 TPHN 的发生率为 12.77%，明显低于亚急性期组的 33.33%（=0.024）。所有患者治疗后 3 个月的有效率为 74.7%。急性期组的有效率为 82.98%，亚急性期组为 63.89%，差异有统计学意义（=0.047）。急性期组 PSQI 评分始终低于亚急性期组（<0.01）。急性期组使用的镇痛药和抗惊厥药剂量低于亚急性期组（<0.01）。所有患者均未发生严重不良反应。
Gasserian 神经节 HL-PRF 联合阻滞是一种有效且安全的技术，可缓解急性/亚急性带状疱疹相关三叉神经痛的疼痛，并预防 TPHN 的发生。
