1. 2022;25;E1047-E1055Effect of Repeated High-voltage Long-duration Pulsed Radiofrequency on Herpetic Neuralgia
   Retrospective Study
   Enming Zhang, MD, Yong Fei, MD, Longsheng Xu, PhD, Bing Huang, MD, and Ming Yao, PhD.

BACKGROUND: Pulsed radiofrequency (PRF) is a commonly used, minimally invasive method to treat herpes zoster neuralgia, but the intensity of standard voltage PRF is limited, resulting in patients not getting a lasting therapeutic effect. The therapeutic effect of repeated high-voltage long-duration PRF on acute herpes zoster neuralgia has not been studied.

OBJECTIVE: How to effectively reduce the incidence of postherpetic neuralgia is a serious challenge for clinicians. The purpose of this study was to investigate the clinical efficacy of repeated high-voltage long-duration pulsed radiofrequency therapy for patients with acute herpetic neuralgia and its preventive effect on postherpetic neuralgia.

STUDY DESIGN: This is a retrospective study.

SETTING: The study was carried out in the Pain Department of the affiliated Hospital of Jiaxing College in Jiaxing, China.

METHODS: Eighty-one patients with acute herpetic neuralgia, who underwent minimally invasive treatment in the Pain Department of Jiaxing First Hospital from January 2020 through December 2020 were retrospectively analyzed. Patients were divided into 3 groups (n = 27 each group) according to treatment method: standard voltage PRF (group S); high-voltage long-duration PRF (group H), and repeated high-voltage long-duration PRF (group R). Pain was assessed according to Numeric Rating Scale (NRS-11) scores and analgesic drug doses were recorded. Blood galectin-3 (gal-3) and interleukin (IL)-6 levels among the 3 groups were compared before treatment and at one, 2, and 4 weeks posttreatment. The incidence of postherpetic neuralgia (PHN) and complications in the 3 groups were recorded.

RESULTS: Pain intensity, blood levels of gal-3 and IL-6, and the dose of orally administered gabapentin capsules and morphine were reduced in all patients after treatment. Compared to group S, patients in group R exhibited lower NRS-11 scores, blood levels of gal-3 and IL-6, and dosages of oral gabapentin capsules after treatment. The incidence of PHN was significantly lower at weeks 4, 8, and 12. No adverse reactions occurred in the 3 groups posttreatment.

LIMITATIONS: Our small sample size is a limitation; we look forward to increasing the sample size in follow-up studies and exploring relevant conclusions in randomized controlled trials.

CONCLUSION: Repeated high-voltage long-duration PRF therapy was an effective treatment for acute herpetic neuralgia and may prevent the occurrence of PHN.

KEY WORDS: Pulsed radiofrequency, dorsal root ganglion, herpes zoster, postherpetic neuralgia