Abstract
To investigate the effects of dorsal root ganglion destruction in patients with postherpetic neuralgia (PHN). Seventy-two patients with PHN selected were randomly divided into two groups (n=36). Group A was the control group (treated by injection) and group B was the group of dorsal root ganglion destruction by adriamycin. Visual analog scale scores (VAS), SAS, SF-MPQ scores. Clinical effects and therapy safety were evaluated before therapy, one week, three and six months after therapy. Forty-four patients were available for intention-to-treat analysis. The average pain scores on the Likert scale were significantly reduced at each point in group B. Patients in group B reported clinical effectiveness at six months as excellent response, good response, improved but unsatisfactory or unchanged 16, 12 and 8.VAS scores at each time point after the operation were lower than that before operation and in group A, there was significant difference. Patients showed significant improvement in sleep scores in group B. There was significant difference at T2 in group A than T1. There was no significant difference in group A at T3, T4 after the operation than that before operation. Between group comparison: there was significant difference between group A and group B at each time point after the operation. Dorsal root ganglion destruction by adriamycin under guidance of C-arm perspective, the puncture operation was accurate without any adverse reaction or serious complications, which could effectively relieve pain of patients with postherpetic neuralgia, but the long-term effects needed further study.
Highlights
Postherpetic neuralgia(PHN) is often characterized by a combination of throbbing or burning pain, intermittent sharp pains, altered sensory perception, including paresthesia and allodynia
PHN can dramatically affect a patient’s quality of life and function The pain is neuropathic in nature and may have a significant impact on the patient’s quality of life and functional status, in the elderly in whom postherpetic neuralgia is more prevalent[5,6]
Implantable spinal infusion devices, neural stimulators, and skin resection have been used in the treatment of severe or intractable postherpetic neuralgia
Summary
MethodsPostherpetic neuralgia(PHN) is often characterized by a combination of throbbing or burning pain, intermittent sharp pains, altered sensory perception, including paresthesia and allodynia PHN can dramatically affect a patient’s quality of life and function The pain is neuropathic in nature and may have a significant impact on the patient’s quality of life and functional status, in the elderly in whom postherpetic neuralgia is more prevalent[5,6]. In clinical practice these agents frequently result in poor pain relief and intolerable side-effects. Opiates frequently cause intolerable side effects; in addition, many patients and physicians are still reticent to utilize opiates for chronic nonmalignant pain. Destructive procedures like nerve sectioning, DREZ (dorsal root rhizotomy) lesions, cordotomy cannot be recommended[13]. Nonpharmacologic therapies are not first-line treatment options till today, The aim of the present study is to investigate the effects of dorsal root ganglion destruction by adriamycin in patients with postherpetic neuralgia
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