Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial
Caused by viral infection, postherpetic neuralgia (PHN) is the most common chronic neuropathic pain. Various treatment modalities such as early use of nerve block therapy (NBT) and pulsed radiofrequency (PRF) have been studied in reducing pain, however, no consistent success was achieved in all the...
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PeerJ Inc.
2018-06-01
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| Online Access: | https://peerj.com/articles/4852.pdf |
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| author | Dan Li Guohua Sun Hanzhe Sun Yanjuan Wang Zhiping Wang Jianping Yang |
| author_facet | Dan Li Guohua Sun Hanzhe Sun Yanjuan Wang Zhiping Wang Jianping Yang |
| author_sort | Dan Li |
| collection | DOAJ |
| description | Caused by viral infection, postherpetic neuralgia (PHN) is the most common chronic neuropathic pain. Various treatment modalities such as early use of nerve block therapy (NBT) and pulsed radiofrequency (PRF) have been studied in reducing pain, however, no consistent success was achieved in all the patients treated with single regimen. The combined therapy of PRF and NBT with different targeting mechanism are of interest and remains to be determined. Here we investigated the combined effects of pulsed radiofrequency (PRF) with nerve block therapy (NBT) in PHN patients in a prospective randomized clinical trial. Sixty PHN patients were divided into four groups (n = 15 each): the conventional puncture group (group CP), the nerve block therapy group (group NB), the PRF group (group PRF), and the combined treatment group (PRF combined with nerve block therapy (group CT). To evaluate the extent of remission of hyperalgesia, we recorded the visual analogue scale (VAS) scores during cotton swab reaction before and after treatment and in the resting and active pain states. In addition, blood samples were collected and plasma cytokine and neuropeptides such as interleukin-6 (IL-6), substance P (SP), and β-endorphin (β-EP) were measured by enzyme-linked immunosorbent assay (ELISA) at the admission (basic state), before the operation, and at 12 h postoperatively. The number of adverse events (nausea, vomiting, constipation, puncture point hemorrhage, swelling and redness) within 12 h of the treatment were also documented. Our results showed that VAS scores during cotton swab reaction decreased after treatment in all patients (p < 0.05). Compared to group CP, plasma IL-6 and SP levels decreased (p < 0.05) and β-EP levels increased (p < 0.05) in groups NB, PRF, and CT. There were no significant differences in adverse events among groups (p > 0.05). We found that PRF in combination with NBT increased β-EP levels and decreased plasma IL-6 and SP, thereby alleviating pain and hyperalgesia in PHN patients. Taken together, our data suggest combined therapy of PRF and NBT is effective and safe for PHN patients. |
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| language | English |
| last_indexed | 2024-03-09T08:17:22Z |
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| spelling | doaj.art-2137f0dd99764310a3b91affe4aeada22023-12-02T22:00:55ZengPeerJ Inc.PeerJ2167-83592018-06-016e485210.7717/peerj.4852Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trialDan Li0Guohua Sun1Hanzhe Sun2Yanjuan Wang3Zhiping Wang4Jianping Yang5Department of Anesthesiology, Wuxi People’s Hospital, Wuxi, ChinaDepartment of Anesthesiology, Wuxi People’s Hospital, Wuxi, ChinaDepartment of Anesthesiology, Wuxi People’s Hospital, Wuxi, ChinaDepartment of Anesthesiology, Wuxi People’s Hospital, Wuxi, ChinaDepartment of Anesthesiology, Wuxi People’s Hospital, Wuxi, ChinaDepartment of Anesthesiology, The First Hospital Affiliated to Soochow University, Suzhou, ChinaCaused by viral infection, postherpetic neuralgia (PHN) is the most common chronic neuropathic pain. Various treatment modalities such as early use of nerve block therapy (NBT) and pulsed radiofrequency (PRF) have been studied in reducing pain, however, no consistent success was achieved in all the patients treated with single regimen. The combined therapy of PRF and NBT with different targeting mechanism are of interest and remains to be determined. Here we investigated the combined effects of pulsed radiofrequency (PRF) with nerve block therapy (NBT) in PHN patients in a prospective randomized clinical trial. Sixty PHN patients were divided into four groups (n = 15 each): the conventional puncture group (group CP), the nerve block therapy group (group NB), the PRF group (group PRF), and the combined treatment group (PRF combined with nerve block therapy (group CT). To evaluate the extent of remission of hyperalgesia, we recorded the visual analogue scale (VAS) scores during cotton swab reaction before and after treatment and in the resting and active pain states. In addition, blood samples were collected and plasma cytokine and neuropeptides such as interleukin-6 (IL-6), substance P (SP), and β-endorphin (β-EP) were measured by enzyme-linked immunosorbent assay (ELISA) at the admission (basic state), before the operation, and at 12 h postoperatively. The number of adverse events (nausea, vomiting, constipation, puncture point hemorrhage, swelling and redness) within 12 h of the treatment were also documented. Our results showed that VAS scores during cotton swab reaction decreased after treatment in all patients (p < 0.05). Compared to group CP, plasma IL-6 and SP levels decreased (p < 0.05) and β-EP levels increased (p < 0.05) in groups NB, PRF, and CT. There were no significant differences in adverse events among groups (p > 0.05). We found that PRF in combination with NBT increased β-EP levels and decreased plasma IL-6 and SP, thereby alleviating pain and hyperalgesia in PHN patients. Taken together, our data suggest combined therapy of PRF and NBT is effective and safe for PHN patients.https://peerj.com/articles/4852.pdfNerve block therapyPulsed radiofrequencyPostherpetic neuralgia |
| spellingShingle | Dan Li Guohua Sun Hanzhe Sun Yanjuan Wang Zhiping Wang Jianping Yang Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial PeerJ Nerve block therapy Pulsed radiofrequency Postherpetic neuralgia |
| title | Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial |
| title_full | Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial |
| title_fullStr | Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial |
| title_full_unstemmed | Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial |
| title_short | Combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients: a randomized clinical trial |
| title_sort | combined therapy of pulsed radiofrequency and nerve block in postherpetic neuralgia patients a randomized clinical trial |
| topic | Nerve block therapy Pulsed radiofrequency Postherpetic neuralgia |
| url | https://peerj.com/articles/4852.pdf |
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