Abstract

BackgroundPostherpetic neuralgia (PHN) is common in elderly patients and can be alleviated by pulsed radiofrequency (PRF). However, PRF treatments display different efficacy on different nerves. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided PRF modulation on thoracic dorsal root ganglion (DRG) or intercostal nerve (ICN) for PHN in aged patients and to provide a theoretical basis for clinical treatment.MethodsWe classified aged patients into two groups, DRG group and ICN group, based on the needle tip position. Visual analogue scale (VAS) and concise health status questionnaire (Short-form 36 health/survey questionnaire, SF-36) were used to evaluate the pain intensity and the life quality of the patients before and 2, 4 and 12 weeks after the PRF treatments. We also recorded the adverse reactions during the treatments.ResultsAfter the PRF treatment, the scores of VAS and SF-36 (assessing general health perception, social function, emotional role, mental health, and pain) improved significantly in both groups (P < 0.05). The mean VAS score in the DRG group was significantly lower than that in the ICN group 2 weeks after treatment, and remained for 12 weeks. The SF-36 scores in the DRG group were significantly higher than those in the ICN group (P < 0.05). We found a similar incidence of adverse reactions between the two groups (P > 0.05).ConclusionsPRF therapy is safe and effective for elderly patients with postherpetic neuralgia. However, PRF treatment in dorsal root ganglion is superior to that in intercostal nerve with improving VAS and SF-36 scores to a greater extent in older patients.Trial registrationChiCTR2100044176.

Highlights

  • Postherpetic neuralgia (PHN) is a chronic pain caused by varicella-zoster virus infection, which always occurs among older adults

  • P-values < 0.050 is regarded as statistically significant. In this retrospective study, we collected the data of 205 aged patients who underwent pulsed radiofrequency (PRF)

  • We found no significant differences in age, gender, pain duration, or other medical history features between the patients in the dorsal root ganglion (DRG) and intercostal nerve (ICN) groups (P > 0.05)

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Summary

Introduction

Postherpetic neuralgia (PHN) is a chronic pain caused by varicella-zoster virus infection, which always occurs among older adults. A variety of treatments is applied into the clinical practice, which include drug therapy and minimally invasive therapeutic procedures (nerve blocks, pulsed radiofrequency, neurolysis, and so on). Drug treatments are unlikely to fundamentally solve the patients’ clinical symptoms, and some patients have to cease the medications due to their side effects, especially the elderly [5]. Postherpetic neuralgia (PHN) is common in elderly patients and can be alleviated by pulsed radiofrequency (PRF). PRF treatments display different efficacy on different nerves. The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided PRF modulation on thoracic dorsal root ganglion (DRG) or intercostal nerve (ICN) for PHN in aged patients and to provide a theoretical basis for clinical treatment

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