Ultrasound-guided Pulsed Radiofrequency in the Management of Thoracic Postherpetic Neuralgia

Makharita, Mohamed Y.; Bendary, Hanaa M El; Sonbul, Zainab; Ahmed, Salma E S; Latif, Mahmoud Abd El

doi:10.1097/ajp.0000000000000629

Cited by 28 publications

(24 citation statements)

References 23 publications

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“…With treatment, all patients had significantly deceased VAS scores and increased SF-36 scores during the post-operative 12-month follow-up period, proving the desirable efficacy of PRF treatment. Despite the recurrence of pain in some patients from 3 to 12 months after the operation, most patients were satisfied with the treatment outcomes, which is consistent with previous research results (Kim et al, 2008;Makharita et al, 2018).…”

Section: Discussionsupporting

confidence: 90%

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

et al. 2020

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BackgroundPostherpetic 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.MethodsThis 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.ResultsVisual 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 P < 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 P < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both P < 0.01). A small number of patients from each group (n ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all P > 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 P < 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.ConclusionCompared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.

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Section: Discussionsupporting

confidence: 90%

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

et al. 2020

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“…Elderly patients are prone to postherpetic neuralgia (PHN) following VZV-induced herpes zoster [ 25 ]. Thoracic, cervical, and trigeminal nerves are commonly involved in PHN [ 26 , 27 ], which may cause anxiety, depression, sleep disorders, and other complications. As a result, the life quality of elderly patients was seriously reduced [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Bioinformatics Analysis of Genes and Mechanisms in Postherpetic Neuralgia

Qiu

Hao

Cheng

et al. 2020

Pain Research and Management

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Objective. Elderly patients are prone to postherpetic neuralgia (PHN), which may cause anxiety, depression, and sleep disorders and reduce quality of life. As a result, the life quality of patients was seriously reduced. However, the pathogenesis of PHN has not been fully elucidated, and current treatments remain inadequate. Therefore, it is important to explore the molecular mechanism of PHN. Methods. We analyzed the GSE64345 dataset, which includes gene expression from the ipsilateral dorsal root ganglia (DRG) of PHN model rats. Differentially expressed genes (DEGs) were identified and analyzed by Gene Ontology. Protein-protein interaction (PPI) network was constructed. The miRNA associated with neuropathic pain and inflammation was found in miRNet. Hub genes were identified and analyzed in Comparative Toxicogenomics Database (CTD). miRNA-mRNA networks associated with PHN were constructed. Results. A total of 116 genes were up-regulated in the DRG of PHN rats, and 135 genes were down-regulated. Functional analysis revealed that variations were predominantly enriched for genes involved in neuroactive ligand-receptor interactions, the Jak-STAT signaling pathway, and calcium channel activity. Eleven and thirty-one miRNAs associated with neuropathic pain and inflammation, respectively, were found. Eight hub genes (S1PR1, OPRM1, PDYN, CXCL3, S1PR5, TBX5, TNNI3, MYL7, PTGDR2, and FBXW2) associated with PHN were identified. Conclusions. Bioinformatics analysis is a useful tool to explore the mechanism and pathogenesis of PHN. The identified hub genes may participate in the onset and development of PHN and serve as therapeutic targets.

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“…Journal of International Medical Research PRF þ NB, 17 one study focused on PRF þ NB þ SC, 19 three studies focused on SC, 23,24,26 one study focused on SC þ NB, 24 one study focused on SC þ NB þ O3 injection, 24 and one study focused on SGB. 25 The detailed parameters, methods, and drug dosages are listed in Table 1.…”

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confidence: 99%

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

et al. 2020

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Objective We aimed to perform a network meta-analysis that combined both direct and indirect evidence to compare the relative efficacy of interventional therapies to treat patients with postherpetic neuralgia (PHN) and to determine the treatments’ superiority and validity. Method A conventional paired meta-analysis was performed. This was followed by a network meta-analysis using the Bayesian framework. Results Botulinum toxin type A and pulsed radiofrequency (PRF) were the two most effective individual interventions. For combination therapy, PRF + nerve block (NB) was the best choice, followed by subcutaneous injection or local infiltration (SC) + NB + ozone (O3). However, the combination of PRF + NB + SC showed reduced the efficacy compared with each treatment and was highly invasive for patients. After a long-term follow-up, PRF was shown to be the most effective therapy for treating patients with PHN. Conclusions Regular anti-neuropathic drug administration that was accompanied by interventional therapies at an early stage is the best choice to treat patients with PHN. Appropriate combinations of different interventions show improved pain relief. Clinicians should manage therapeutic regimens on the basis of the patients specific condition and existing measures and strive to achieve personalized treatment.

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Ultrasound-guided Pulsed Radiofrequency in the Management of Thoracic Postherpetic Neuralgia

Abstract: Ultrasound-guided PRF for ICNs in combination with pharmacotherapy seems to be a safe and effective treatment modality for postherpetic neuralgia.

Cited by 28 publications

References 23 publications

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

Bioinformatics Analysis of Genes and Mechanisms in Postherpetic Neuralgia

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

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