Randomized and controlled prospective trials of Ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for lower back post-herpetic neuralgia.

Abstract

OBJECTIVE:

To evaluate the efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for lower back post-herpetic neuralgia.

MATERIALS AND METHODS:

128 cases of lower back or anterior abdominal wall acute post-herpetic neuralgia patients were selected. They were randomly divided into two groups. Group A: oral treatment only with gabapentin + celecoxib + amitriptyline. Group B: while taking these drugs, patients were treated with radiofrequency (RF) pulses using a portable ultrasound device using the paravertebral puncture technique. In both groups, sudden outbreaks of pain were treated with immediate release 10mg morphine tablets. Visual analogue scale (VAS) was used for pain score, Pittsburgh Sleep Quality Index scale (PSQI) was used to evaluate sleep quality and morphine consumption were recorded at different time points, before and after treatment. Treatment efficiency was calculated while the occurrence of complications was documented.

RESULTS:

At each time point after treatment, VAS scores were lower, but scores in the RF group was significantly lower than those of the oral-only group. In terms of sleep quality scores and morphine consumption between the two groups, the RF group was significantly lower than the oral-only group. During the procedure no error occurred with needle penetrating the abdominal cavity, chest, offal or blood vessels.

CONCLUSIONS:

Ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment of lower back or anterior abdominal wall post-herpetic neuralgia proved effective by reducing morphine use in patients and led to fewer adverse reactions.

• Authors: Z B Pi, H Lin, G D He, Z Cai, X Z Xu
• Journal: La Clinica terapeutica (Clin Ter) Vol. 166 Issue 5 Pg. e301-5 ( 2015) ISSN: 1972-6007 [Electronic] Italy
• PMID: 26550813 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Amines
• Analgesics
• Cyclohexanecarboxylic Acids
• Amitriptyline
• gamma-Aminobutyric Acid
• Gabapentin
• Morphine
• Celecoxib

Topics

• Administration, Oral
• Adult
• Aged
• Amines (administration & dosage)
• Amitriptyline (administration & dosage)
• Analgesics (administration & dosage)
• Celecoxib (administration & dosage)
• Cyclohexanecarboxylic Acids (administration & dosage)
• Female
• Gabapentin
• Humans
• Low Back Pain (drug therapy, therapy)
• Male
• Middle Aged
• Morphine (administration & dosage)
• Neuralgia, Postherpetic (drug therapy, therapy)
• Pain Measurement
• Prospective Studies
• Pulsed Radiofrequency Treatment (methods)
• Sleep
• Spinal Nerves (physiopathology)
• gamma-Aminobutyric Acid (administration & dosage)