Abstract
ObjectivesTrigeminal postherpetic neuralgia (TPHN) often presents with moderate to severe pain, hyperalgesia, and allodynia. Conventional analgesic treatments are poorly effective, which seriously affects the quality of life. This retrospective study aimed to evaluate the efficacy of pulsed radiofrequency (PRF) for the treatment of TPHN.MethodsA total of 90 TPHN patients were selected between January 2014 and December 2016 in the Department of Pain Management, Shengjing Hospital, China Medical University. Patients were randomly divided into two groups according to the order of enrollment (n = 45 per group): group A, peripheral nerve (supraorbital nerve, infraorbital nerve and mental nerve) PRF; group B, gasserian ganglion PRF. Follow-up assessments of visual analogue scale (VAS) pain assessment, SF-36 health status questionnaire, total efficiency rate, and drug dosage of anticonvulsants and opioid analgesics were performed at time points of 1 week, 1 month, 3 months, 6 months, and 1 year after surgery.ResultsAt each postsurgery time point, the VAS decreased, SF-36 (physical and mental components) increased, and drug dosage of anticonvulsants and opioids analgesics decreased in both treatment groups; values at each time point were significantly different from presurgery values (P < 0.05). Compared with group A, VAS decreased, SF-36 increased, and dosage of anticonvulsants and opioids analgesics decreased significantly in group B (P < 0.05). The total efficiency rates one year after surgery in group A and group B were 68.9 and 86.7%, respectively. The total efficiency rate of group B was statistically higher than that of group A (P < 0.05).ConclusionPRF relieved TPHN, and gasserian ganglion PRF was more effective than peripheral nerve PRF. The method was effective and improved the quality of life of the patients. PRF is recommended as a treatment for TPHN.
Highlights
Postherpetic neuralgia (PHN) is a persistent neuropathic pain that remains after a herpes zoster rash has healed
A total of 90 Trigeminal postherpetic neuralgia (TPHN) patients were selected between January 2014 and December 2016 in the Department of Pain Management, Shengjing Hospital, China Medical University (Figure 1)
The point of supraorbital nerve puncture was located in the supraorbital orifice, immediately above the orbital ridge, using the medial line through the pupil as a reference for the supraorbital nerve; The point of infraorbital nerve puncture was located in the infraorbital foramen, can be approximated by having the patient look straight ahead and imagining a line down from the pupil to the inferior border of the infraorbital ridge, bicuspid teeth, and mental foramen; The point of mental nerve puncture was located in the mental foramen, located halfway between the upper and the lower edge of the mandible in direct line with the second bicuspid
Summary
Postherpetic neuralgia (PHN) is a persistent neuropathic pain that remains after a herpes zoster rash has healed. It is the most common complication of herpes zoster infection. The incidence and treatment costs of PHN increase with age (Sicras-Mainar et al, 2012; Duracinsky et al, 2014). Herpes zoster infection of the trigeminal nerve is a high risk factor for PHN. Trigeminal postherpetic neuralgia (TPHN) often presents with moderate to severe pain, hyperalgesia, and allodynia. Conventional analgesic treatments are ineffective, a consequence that greatly affects the quality of life and increases social burden (Gialloreti et al, 2010; Lovell, 2015). Finding a treatment that can effectively relieve TPHN and improve a patient’s quality of life is imperative
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