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Clinical study of the preventive effect of pulsed radiofrequency and continuous epidural block on postherpetic
Ping Xu1, Yong Fei1, Enming Zhang2
1Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, Jiaxing, China.
Objective:
In this study, patients with acute herpes zoster neuralgia were respectively treated with continuous epidural block and pulsed radio frequency therapy to compare the similarities and differences of the two treatment methods in preventing the incidence of PHN, as well as the efficacy of acute herpes zoster neuralgia and observe the surgical complications.
Methods:
Ninety patients with herpes zoster neuralgia whose course of disease was less than 1 month were randomly divided into two groups according to the type of surgery: Continuous Epidural Block (CEB group) and Pulsed Radio Frequency (PRF group). The incidence of PHN in January, March and June was recorded. VAS scores, PSQI scores and the dosage of gabapentine capsules and Tramadol hydrochloride sustained-release tablets were recorded before surgery and 1 day, 1 week, 1 month, 3 months and 6 months after surgery. Peripheral blood Gal-3 and IL-6 levels before surgery, 1 week, 2 weeks and 4 weeks after surgery; Surgical complications; The duration of hospital stay and so on were used to evaluate the clinical effect of the operation.
Results:
The incidence of PHN in CEB group at 1 month, 3 months and 6 months after surgery was lower than that in PRF group, and the differences were statistically significant (P < 0.05). Pain intensity and PSQI were decreased in all patients after treatment. Compared with PRF group, VAS score and PSQI in CEB group decreased at 1 week, 1 month, 3 months and 6 months after surgery, and the differences were statistically significant (P < 0.05). Compared with before treatment, the levels of Gal-3 and IL-6 in peripheral blood of all patients were decreased after treatment, and the differences were statistically significant (P < 0.05). Compared with PRF group, peripheral blood Gal-3 and IL-6 levels in CEB group decreased at 1 and 4 weeks after treatment, and the differences were statistically significant (P < 0.05). The doses of gabapentin capsules and Tramadol hydrochloride sustained-release tablets in CEB group were lower than those in PRF group at 1 month, 3 months and 6 months after surgery, and the differences between the two groups were statistically significant (P < 0.05). There was one patient with puncture site infection in the CEB group, and the hospital stay in the CEB group was longer than that in the PRF group.
Conclusions:
Both methods can significantly relieve the pain of patients with acute herpes zoster neuralgia and reduce the incidence of PHN, but there is a risk of puncture site infection., and long hospital stay. PRF treatment has short hospital stay, less injury and strong repeatability.
