Efficacy of chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency in treating upper limb postherpetic neuralgia

Abstract

Objective To evaluate the efficacy of chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency in treating upper limb postherpetic neuralgia (PHN). Methods Forty-two patients of both sexes with upper limb PHN, aged 48-75 yr, were divided into 2 groups (n=21 each) using a random number table method: chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency group (TSNM+ PR group) and pulsed radiofrequency group (PR group). TSNM+ PR group was treated using chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency, and PR group received pulsed radiofrequency alone.The occurrence of treatment-related adverse reactions was recorded.Numeric rating scale scores were recorded preoperatively and at 1 day and 1 and 3 months after operation, and the efficacy was graded.The effective treatment and pain recurrence were recorded 3 months after operation.Quantitative sensory nerve tests were performed to record the current perception threshold before operation and on 1 day, 1 month and 3 months after operation. Results Compared with PR group, numeric rating scale score was significantly decreased, the therapeutic effect was enhanced, the rate of effective treatment was increased, the recurrence rate of pain was decreased at 1 and 3 months after surgery, the current perception threshold at 250 and 5 Hz on the ipsilateral side was increased at 1 and 3 months after surgery in TSNM+ PR group (P<0.05). No treatment-related adverse reactions were found in two groups. Conclusion Chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency provides reliable therapeutic effect and higher safety for upper limb PHN. Key words: Neuralgia, postherpetic; Limbs; Sympathectomy, chemistry; Catheter ablation