scholarly journals High-Voltage, Long-Duration Pulsed Radiofrequency on Gasserian Ganglion Improves Acute/Subacute Zoster-Related Trigeminal Neuralgia: A Randomized, Double-Blinded, Controlled Trial

2019 ◽  
Vol 4 (22;4) ◽  
pp. 361-368
Author(s):  
Tao Song
Keyword(s):  
Trigeminal Neuralgia ◽  
High Voltage ◽  
Postherpetic Neuralgia ◽  
Sham Group ◽  
Short Form ◽  
Gasserian Ganglion ◽  
Pulsed Radiofrequency ◽  
Long Duration ◽  
Sf 36 ◽  
Double Blinded

Background: Trigeminal postherpetic neuralgia is a severe neuropathic pain and often refractory to existing treatment, it develops secondary to herpes zoster-infected Gasserian ganglion. Therefore, it is important to prevent the transition of acute/subacute zoster-related pain to trigeminal postherpetic neuralgia. Despite numerous studies, the optimal intervention that reduces trigeminal postherpetic neuralgia incidence is still unknown. Objectives: This study aimed to evaluate the efficacy and safety of high-voltage, long-duration pulsed radiofrequency (PRF) on the Gasserian ganglion in patients with acute/subacute zosterrelated trigeminal neuralgia. 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 trigeminal neuralgia were equally randomly assigned into 2 groups. The electrode needle punctured the Gasserian ganglion guided by computed tomography in every patient. High-voltage, long-duration PRF at 42°C for 900 seconds was applied in the PRF group (n = 48). It was also applied in the sham group (n = 48) without radiofrequency energy output. The therapeutic effects were evaluated using a visual analog scale (VAS) and the 36-Item Short Form Health Survey (SF-36) at different time points. The average dosage of pregabalin (mg/d) administrated within the first month after treatment was also recorded. Results: The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group at different time points after treatment (P < 0.01). The SF-36 scores, which included physical functioning, physical role, bodily pain, general health perceptions, vitality, social function, emotional role, and the mental health index, were significantly improved at the sixth month after treatment in the PRF group compared with the sham group (P < 0.01). The average dosage of pregabalin administered (mg/d) within the first month after treatment was also significantly reduced in the PRF group compared with the sham group (P < 0.01). There were no bleeding, infection, or other severe side effects in both groups. Limitations: Single center study, relatively small number of patients. Conclusions: High-voltage, long-duration PRF on the Gasserian ganglion is an effective and safe therapeutic alternative for patients with acute/subacute zoster-related trigeminal neuralgia. Key words: Pulsed radiofrequency, zoster-related trigeminal neuralgia, visual analog scale, 36- Item Short Form Health Survey

scholarly journals Different Pulsed Radiofrequency Modes on Gasserian Ganglion Improved Acute/subacute Zoster-related Trigeminal neuralgia: A Randomized, Double-Blinded, Controlled Trial

2020 ◽  
Author(s):  
Cheng-fu Wan ◽  
Tao Song
Keyword(s):  
Trigeminal Neuralgia ◽  
High Voltage ◽  
Short Form ◽  
Controlled Trial ◽  
Gasserian Ganglion ◽  
Pulsed Radiofrequency ◽  
Clinical Trial Registration ◽  
Time Points ◽  
Long Duration ◽  
Sf 36

Abstract Background: Trigeminal postherpetic neuralgia (PHN), developed from herpes zoster virus infected on gasserian ganglion, is a severe neuropathic pain and often refractory to existing treatment. Pulsed radiofrequency (PRF) is known to be effective for treating acute/subacute zoster-related pain, but the effectiveness of different PRF mode has not been tested.Objective: This study aimed to investigate the efficacy and safety of different PRF modes on gasserian ganglion in patients with acute/subacute zoster-related trigeminal neuralgia.Methods: 120 patients were equally randomized into 2 groups (n = 60): high-voltage, long-duration PRF(HL-PRF) group and standard PRF(S-PRF) group. One cycle high-voltage, long-duration PRF was applied in HL-PRF group and three cycles standard PRF were performed in S-PRF group. Visual analog scales (VAS), 36-item short form health survey scores (SF-36) and average doses of pregabalin were recorded at different time points. Results: There were significant declined in VAS and SF-36 scores in both two groups at different time point after PRF treatment (P < 0.001). The scores of VAS and SF-36 in HL-PRF group were significantly lower than those in S-PRF group at different time points after treatment (P < 0.05). The dosages of pregabalin were also lower in HL-PRF group at days 3, 14 and 28 after treatment (P < 0.05). There was no serious adverse effect in either group. Conclusion: High-voltage, long-duration PRF on gasserian ganglion is more effective than standard PRF for acute/subacute zoster-related trigeminal neuralgia patients. Clinical Trial Registration: ChiCTR2000038775

scholarly journals Bipolar High-Voltage, Long-Duration Pulsed Radiofrequency Improves Pain Relief in Postherpetic Neuralgia

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E721-E728
Author(s):  
Tao Song
Keyword(s):  
Clinical Trial ◽  
High Voltage ◽  
Postherpetic Neuralgia ◽  
Short Form ◽  
Control Group ◽  
Therapeutic Effects ◽  
Pulsed Radiofrequency ◽  
Long Duration ◽  
Number Of Patients ◽  
Sf 36

Background: Postherpetic neuralgia (PHN) is often refractory to existing treatments. Treatment of the dorsal root ganglion (DRG) using monopolar pulsed radiofrequency (PRF), which is a nonor minimally neurodestructive technique, is not efficacious in all patients. Objectives: This study aimed to determine the safety and clinical efficacy of bipolar highvoltage, long-duration PRF on the DRG in PHN patients. Study Design: Self before-after controlled clinical trial. Setting: Department of Pain Medicine, the First Affiliated Hospital of China Medical University. Methods: Ninety patients diagnosed with PHN for > 3months were included. Bipolar highvoltage, long-duration PRF at 42°C for 900 seconds was applied after the induction of paresthesias covered the regions of hyperalgesic skin. The therapeutic effects were evaluated using a visual analog scale (VAS) and the 36-item Short Form health survey (SF-36) before treatment and one, 4, 8, and 12 weeks after PRF. Results: The VAS scores at one, 4, 8, and 12 weeks after PRF treatment were significantly lower than before treatment (P < 0.001). The SF-36 scores, which included physical functioning, physical role, bodily pain, general health perceptions, vitality, social function, emotional role, and the mental health index, were significantly improved up to 12 weeks after PRF treatment (P < 0.001). No serious adverse effects were identified following treatment. The main adverse reactions included pain, tachycardia, and high blood pressure (especially when the field strength was enhanced). Limitations: Single center study, relatively small number of patients, lack of a control group. Conclusion: Bipolar high-voltage, long-duration PRF on the DRG is an effective and safe therapeutic alternative for PHN patients. This treatment could improve the quality of life of PHN patients. Clinical Trial Registration: NO ChiCTR-OCS-14005461 Key words: Pulsed radiofrequency, postherpetic neuralgia, VAS, SF-36

scholarly journals Efficacy of Pulsed Radiofrequency in the Treatment of Thoracic Postherpetic Neuralgia from the Angulus Costae: A Randomized, Double-Blinded, Controlled Trial

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. 15-25
Author(s):  
Wang Yingwei
Keyword(s):  
Side Effects ◽  
Postherpetic Neuralgia ◽  
Sham Group ◽  
Bodily Pain ◽  
Energy Output ◽  
Radiofrequency Energy ◽  
Pulsed Radiofrequency ◽  
Number Of Patients ◽  
Sf 36 ◽  
Double Blinded

Background: Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that can occasionally occur with PRF treatment is damage to the adjacent tissue and organ. The effectiveness of the angulus costae as a puncture site for PRF has not been tested in thoracic PHN treatment. Objective: The goal of this study was to investigate the therapeutic efficacy and safety of PRF for treating thoracic PHN through the puncture of the angulus costae. Study Design: Prospective, randomized, double-blinded study. Setting: Department of Anesthesiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine. Methods: Ninety-six patients with thoracic (T2-11) PHN were equally randomized assigned into 2 groups. The electrode needle punctured through the angulus costae of each patient guided by x-ray; PRF at 42°C for 120 seconds was applied after inducing paresthesia involving the affected dermatome area. PRF was applied in the PRF group (n = 48) twice. It was also applied in the sham group (n = 48) twice without radiofrequency energy output. The treatment was done once a week for 3 weeks. Tramadol was used for flare pain when the visual analog scale (VAS) ≥ 3. Outcomes Assessment: The therapeutic effect was evaluated by VAS, SF-36 health survey questionnaire, side effects (type, frequency, and onset time) before treatment, at days 3, 7, and 14, and at months one, 2, 3 and 6 after PRF. The average of tramadol (mg/d) administrated within the first month after treatment was also recorded. Results: The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group and lasted for 6 months after treatment (P < 0.05). The SF-36 score, such as physical functioning, physical role, bodily pain, general health perceptions, social function, emotional role, and mental health index were significantly improved until 6 months after treatment in the PRF group compared to the sham group (P < 0.01-0.05). The average dosage of tramadol administered (mg/d) within the first month after treatment was also significantly reduced in the PRF group compared to the sham group (P < 0.05). There were no obvious signs of pneumothorax, bleeding, infection, or other severe side effects in either group (P > 0.05). Limitations: Single center study, relatively small number of patients. Conclusions: The strategy that the angulus costae be used as the PRF puncture point of an electrode needle and the final localization of the needle tip as determined by sensory testing is an effective and safe therapeutic alternative for thoracic PHN treatment. Benefits include that the procedure is minimally invasive, provides short-term pain relief, and improves quality of life. Clinical Trial Registration: NO ISRCTN25588650. Key words: Thoracic, postherpetic neuralgia, pulsed radiofrequency, angulus costae

scholarly journals Efficacy of Pulsed Radiofrequency or Short-Term Spinal Cord Stimulation for Acute/Subacute Zoster-Related Pain: A Randomized, Double- Blinded, Controlled Trial

2021 ◽  
pp. 215-222
Author(s):  
Tao Song
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Rating Scale ◽  
Short Form ◽  
Numeric Rating Scale ◽  
Pulsed Radiofrequency ◽  
Short Term ◽  
Time Points ◽  
Sf 36 ◽  
Double Blinded

Background: Postherpetic neuralgia (PHN) is the final stage of varicella zoster infection and a severe refractory neuropathic pain. Hence preventing transition of herpes zoster-related pain to PHN is a very important therapeutic principle for patients at an early stage, especially for older patients.Both pulsed radiofrequency (PRF) and short-term spinal cord stimulation (stSCS) have been proven to be effective to relieve acute/subacute zoster-related pain. However, which treatment could achieve better analgesic effects remains unclear. Objectives: This study aimed to investigate the therapeutic efficacy and safety of PRF and stSCS in 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 randomized into 2 groups: PRF group and stSCS group. Patients in the different groups were treated with high-voltage, long-duration PRF or stSCS. The therapeutic effects were evaluated using a Numeric Rating 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 with baseline (P < 0.001). The NRS-11 scores in the stSCS group were significantly lower than those in the 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, and vitality could be significantly improved at each time point after treatments in the 2 groups. Some SF-36 scores could be significantly improved at some time points in the stSCS group compared with the PRF group. The rescue drug (pregabalin) dosages were lower in the stSCS group than those in the 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 either group. Limitations: Single-center study, relatively small number of patients. Conclusions: PRF and stSCS are both effective and safe therapeutic alternatives for patients with acute/subacute zoster-related pain, however, stSCS could achieve more pain relief and improvement 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

scholarly journals Effective Treatment of Postherpetic Neuralgia at the First Branch of the Trigeminal Nerve by High-Voltage Pulsed Radiofrequency

2021 ◽  
Vol 12 ◽  
Author(s):  
Hongxi Li ◽  
Yuanyuan Ding ◽  
Yongqiang Zhu ◽  
Zhenkai Han ◽  
Peng Yao
Keyword(s):  
Adverse Events ◽  
Effective Treatment ◽  
Trigeminal Nerve ◽  
High Voltage ◽  
Postherpetic Neuralgia ◽  
Pulsed Radiofrequency ◽  
Treatment Efficiency ◽  
Supraorbital Nerve ◽  
Sf 36 ◽  
Vas Scores

Background: Postherpetic neuralgia (PHN) is one of the most common and serious complications of herpes zoster. PHN of the first branch of the trigeminal nerve is painful and difficult to treat, as no definitive effective treatment is available. The aim of this retrospective study was to observe the efficacy and safety of treatment of PHN of the first branch of the trigeminal nerve with high-voltage pulsed radiofrequency (PRF) of the supraorbital nerve.Methods: Fifty-two patients diagnosed with the PHN of the first branch of the trigeminal nerve at the Department of Pain Management, Shengjing Hospital, China Medical University, between April 2017 and October 2020 were selected. The PRF treatment of the supraorbital nerve was used. The patients were divided into two groups according to the treatment received: group C, conventional PRF group; and group H, high-voltage PRF group. The basic conditions, pain scores, and SF-36 scores of patients before treatment were recorded. Also, intraoperative and postoperative adverse events, visual analog scale (VAS) scores, 36-Item Short Form Health Survey (SF-36) scores at 1 week, 1 month, 3 months, and 6 months of follow-up were recorded. Furthermore, treatment efficiency was followed up at 6 months after treatment.Results: The VAS scores of patients in both groups were significantly lower at all time points after treatment compared with presurgery. VAS scores in group H were lower than those in group C 1, 3, and 6 months after treatment. SF36 scores of patients in group H were better than those in group C 1, 3, and 6 months after treatment. The treatment efficiency at 6 months after treatment was higher in group H than in group C. No serious adverse events occurred in both groups.Conclusion: The efficacy of the high-voltage PRF of the supraorbital nerve in treating the PHN of the first branch of the trigeminal nerve was superior to that of conventional PRF. It was a safe and effective treatment method.

Auricular vagal nerve stimulation in peripheral arterial disease patients

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Gerald Hackl ◽  
Andreas Prenner ◽  
Philipp Jud ◽  
Franz Hafner ◽  
Peter Rief ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Nerve Stimulation ◽  
Short Form ◽  
Therapeutic Option ◽  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Sf 36 ◽  
Peripheral Arterial ◽  
Double Blinded

Abstract. Background: Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. Patients and methods: In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128–236] meters to 345 [95 % CI 227–463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109–210] meters to 268 [95 % CI 182–366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.

scholarly journals PainVision® Apparatus for Assessment of Efficacy of Pulsed Radiofrequency Combined with Pharmacological Therapy in the Treatment of Postherpetic Neuralgia and Correlations with Measurements

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Dong Wang ◽  
Kai Zhang ◽  
ShaoLong Han ◽  
LingZhi Yu
Keyword(s):  
Pain Intensity ◽  
Postherpetic Neuralgia ◽  
Breakthrough Pain ◽  
Short Form ◽  
Persistent Pain ◽  
Pharmacological Therapy ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Pulsed Radiofrequency ◽  
Highly Correlated

Objective. PainVision device was a developed application for the evaluation of pain intensity. The objective was to assess the efficacy and safety of pulsed radiofrequency (PRF) combined with pharmacological therapy in the treatment of postherpetic neuralgia (PHN). We also discussed the correlation of the measurements.Method. Forty patients with PHN were randomized for treatment with PRF combined with pharmacological therapy (PRF group,n=20) or pharmacological therapy (control group,n=20) at postoperative 48 hours. The efficacy measure was pain degree (PD) that was assessed by PainVision and visual analog scale (VAS), short form Mcgill pain questionnaire (SF-Mcgill), and numeric rate scale sleep interference score (NRSSIS). Correlations between PD, VAS, SF-Mcgill, and NRSSIS were determined.Results. The PD for persistent pain (PP) and breakthrough pain (BTP) at postoperative 48 hours assessed by PainVision were significantly lower in PRF group than in control group (PD-PP,P<0.01; PD-BTP,P<0.01). PD and VAS were highly correlated for both persistent pain (r=0.453,ρ=0.008) and breakthrough pain (r=0.64,ρ=0.001).Conclusion. PRF was well tolerated and superior to isolated pharmacological therapy in the treatment of PHN. PainVision device showed great value in the evaluation of pain intensity and PD had an excellent correlation with VAS and SF-Mcgill.

scholarly journals Effects of Pulsed Versus Conventional Versus Combined Radiofrequency for the Treatment of Trigeminal Neuralgia: A Prospective Study

2017 ◽  
Vol 6 (20;6) ◽  
pp. E873-E881
Author(s):  
Ghaydaa A. Ghaydaa A.
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Prospective Study ◽  
University Hospital ◽  
Gasserian Ganglion ◽  
Pulsed Radiofrequency ◽  
Group Setting ◽  
Idiopathic Trigeminal Neuralgia ◽  
Number Of Patients ◽  
A Prospective Study

Background: During radiofrequency bursts of energy are applied to nervous tissue. The clinical advantages of this treatment remain unclear. Objectives: We compared the effectiveness and pain relief for idiopathic trigeminal neuralgia (TN) after continuous radiofrequency (CRF), pulsed radiofrequency (PRF), and combined continuous and pulsed radiofrequency (CCPRF) treatment of the Gasserian ganglion (GG). Study Design: We conducted a randomized prospective study. Forty-three patients were included. Eleven patients were treated with PRF at 42°C for 10 minutes (PRF group), 12 patients received CRF for 270 seconds at 75 °C (CRF group), and 20 patients received PRF for 10 minutes at 42°C followed by CRF for at 60°C for 270 seconds (CCPRF group). Setting: Assuit University Hospital, Pain and Neurology outpatient clinics. Methods: Patients were assessed for pain, satisfaction, and consumption of analgesics at baseline and 7 days, one month, 6 months, 12 months, and 24 months after the procedure. The incidence of complications, anesthesia dolorosa, weakness of muscles of mastication, numbness, and technical complications, was evaluated after the procedure. Results: Excellent pain relief was achieved after 6, 12, and 24 months, respectively in 95%, 85%, and 70% of patients with CCPRF; 75%, 75%, and reduced to 50% among patients with CRF; and 82%, reduced to 9.1%, and 0% of patients with PRF. No complications were recorded in 75% of patients in the CCPRF and PRF groups. There was one case of anesthesia dolorosa, 4 cases of masseter muscle weakness, and 5 cases of severe numbness recorded in the CRF group. Limitation: There was a small number of patients in each group. Conclusion: The best results were observed in the CCPRF group, followed by the CRF group, and then the PRF group.

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