Open AccessFirst Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Author(s) -
EungDon Kim
Publication year - 2017
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2017.e418
Subject(s) - medicine , pulsed radiofrequency , postherpetic neuralgia , neuropathic pain , anesthesia , pain relief
Background: Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsalroot ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is animportant region for pain signal transduction. Sustained abnormal electrical activity to the spinalcord via the DRG in acute herpes zoster can result in neuropathic conditions such as postherpeticneuralgia (PHN). Although the efficacy of pulsed radiofrequency (PRF) application to the DRG invarious pain conditions has been previously reported, the application of PRF to the DRG in patientswith herpes zoster has not yet been studied.Objectives: The aim of the present study was to compare the clinical effects of PRF to the DRG inpatients with herpes zoster to those of PRF to the DRG in patients with PHN.Study Design: Retrospective comparative study.Setting: University hospital pain center in Korea.Methods: The medical records of 58 patients who underwent PRF to the DRG due to zosterrelated pain (herpes zoster or PHN) were retrospectively analyzed. Patients were divided into 2groups according to the timing of PRF after zoster onset: an early PRF group (within 90 days) anda PHN PRF group (more than 90 days). The efficacy of PRF was assessed by a numeric rating scale(NRS) and by recording patient medication doses before PRF and at one week, 4 weeks, 8 weeks,and 12 weeks after PRF.Results: Pain intensity was decreased after PRF in all participants. However, the degree of painreduction was significantly higher in the early PRF group. Moreover, more patients discontinuedtheir medication in the early PRF group, and the PRF success rate was also higher in the early PRFgroup.Limitations: The relatively small sample size from a single center, short duration of review ofmedical records, and the retrospective nature of the study.Conclusions: PRF to the DRG is a useful treatment for treatment-resistant cases of herpes zosterand PHN. Particularly in herpes zoster patients with intractable pain, application of PRF to the DRGshould be considered for pain control and prevention of PHN.Key words: Pulsed radiofrequency, dorsal root ganglion, herpes zoster, postherpetic neuralgia