Open AccessEfficacy of Pulsed Radiofrequency or Short-Term Spinal Cord Stimulation for Acute/Subacute Zoster-Related Pain: A Randomized, Double- Blinded, Controlled Trial
Author(s) -
Chengfu Wan,
Tao Song
Publication year - 2021
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.2021/24/215
Subject(s) - medicine , postherpetic neuralgia , pulsed radiofrequency , randomized controlled trial , neuropathic pain , pregabalin , anesthesia , neuralgia , analgesic , transcutaneous electrical nerve stimulation , refractory (planetary science) , surgery , pain relief , physics , alternative medicine , pathology , astrobiology
Background: Postherpetic neuralgia (PHN) is the final stage of varicella zoster infection and asevere refractory neuropathic pain. Hence preventing transition of herpes zoster-related pain toPHN is a very important therapeutic principle for patients at an early stage, especially for olderpatients.Both pulsed radiofrequency (PRF) and short-term spinal cord stimulation (stSCS) have beenproven to be effective to relieve acute/subacute zoster-related pain. However, which treatmentcould achieve better analgesic effects remains unclear.Objectives: This study aimed to investigate the therapeutic efficacy and safety of PRF and stSCSin patients with acute/subacute zoster-related pain.Study Design: Prospective, randomized, double-blinded study.Setting: Department of Pain Medicine, the First Affiliated Hospital of China Medical University.Methods: Ninety-six patients with acute/subacute zoster-related pain were equally randomizedinto 2 groups: PRF group and stSCS group. Patients in the different groups were treated withhigh-voltage, long-duration PRF or stSCS. The therapeutic effects were evaluated using a NumericRating Scale (NRS-11) and the 36-Item Short Form Health Survey (SF-36) at different time points.The average dose of pregabalin (mg/d) administrated at different time points was also recorded.Results: The posttreatment NRS-11 scores in the 2 groups were significantly lower compared withbaseline (P < 0.001). The NRS-11 scores in the stSCS group were significantly lower than those inthe PRF group at 30 and 180 days after treatments (P < 0.05). The SF-36 scores of general health,social function, role-emotional, mental health, bodily pain, physical function, physical role, andvitality could be significantly improved at each time point after treatments in the 2 groups. SomeSF-36 scores could be significantly improved at some time points in the stSCS group compared withthe PRF group. The rescue drug (pregabalin) dosages were lower in the stSCS group than those inthe PRF group at days 90 and 180 after treatments. There was no bleeding at the puncture site,infection, postoperative paresthesia, nerve injury, or any other serious adverse effects in eithergroup.Limitations: Single-center study, relatively small number of patients.Conclusions: PRF and stSCS are both effective and safe therapeutic alternatives for patientswith acute/subacute zoster-related pain, however, stSCS could achieve more pain relief andimprovement of life quality compared with PRF.Key words: Pulsed radiofrequency, short-term spinal cord stimulation, zoster-related pain,Numeric Rating Scale, 36-Item Short Form Health Survey