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[The efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for aged lower back post-herpetic neuralgia].

[The efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for aged lower back post-herpetic neuralgia].

Zhonghua Yi Xue Za Zhi. 2018 Mar 13;98(10):733-737

Authors: Pi ZB, Zhang JK, Peng Y, Jin Y, Lin H

Summary
Goal: To judge the efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency remedy of decrease again post-herpetic neuralgia. Strategies: 100 and twenty-eight instances of decrease again or anterior belly wall acute post-herpetic neuralgia sufferers have been enrolled. They have been randomly divided into two teams. Group A: oral remedy solely with gabapentin+ celecoxib+ amitriptyline. Group B: whereas taking these medicine, sufferers have been handled with radiofrequency pulses utilizing a conveyable ultrasound system and the paravertebral puncture method.In each teams, sudden outbreaks of ache have been handled with instant launch 10 mg morphine tablets. Earlier than and one week, two weeks, 4 weeks, eight weeks after remedy, visible analogue scale (VAS) was used for ache rating, Pittsburgh sleep high quality index scale (PSQI) was used to judge sleep high quality, and morphine consumption was recorded. Eight weeks after remedy analgesic efficacy was evaluated. Therapy effectivity and vital effectivity was calculated whereas the incidence of issues have been documented. Outcomes: Within the management group, the VAS of T1,T2,T3 and T4 have been 6.7 ±1.2, 5.2 ± 1.zero, three.three ±1.1, three.zero±zero.9.Nevertheless, on the similar time factors, the VAS within the remedy group have been three.1±1.zero, 2.2±zero.7, 1.four±zero.5, 1.2±zero.5, respectively.The radio frequency group decreased considerably in contrast with the management group, the distinction was statistically vital (t=17.925, 19.662, 12.580, 13.987, all P<zero.05). 4 weeks after remedy, the TNF-? within the management group was (11.04±2.36)ng/L, and the TNF-? within the radio frequency group was (Eight.07±2.13) ng/L. After the remedy, the TNF-? of the radio frequency group was decrease than the management group, and the distinction was statistically vital (t=-6.267, P<zero.05). The IL-1? within the management group was (three.47±1.09) ng/L after remedy.The IL-1? within the radio frequency group was (1.96 ±zero.56) ng/L, the IL-1? within the radio frequency group was decrease than the management group and the distinction was statistically vital (t=-Eight.266, P<zero.05). Pearson correlation evaluation confirmed that earlier than and after the remedy of TNF-? have been positively correlated with VAS rating (r=zero.455, zero.327, all P<zero.05). IL-1? earlier than and after remedy have been positively correlated with VAS rating (r=zero.369, zero.357, all P<zero.05). At T1,T2,T3 and T4, PSQI within the management group have been Eight.5±1.5, 7.three±1.four, 6.2±1.three and 6.zero±zero.9 respectively.PSQI within the radio frequency group on the similar time factors have been 6.5±1.four, 5.1±1.2, four.zero±1.1 and three.9±zero.5.Comparability between the 2 teams after remedy, radio frequency group was decrease than the management group considerably, and the distinction was statistically vital (t=7.798, 9.545, 10.335, 16.318, all P<zero.05). Morphine consumption of the management group at T1,T2,T3,T4 have been (22.5±2.2), (15.5±2.9), (6.Eight±1.5) and (four.2±zero.9)mg.Nevertheless, morphine consumption of the radio frequency group have been (13.2±2.5), (7.2±2.7), (three.2±zero.6) and (2.2±zero.5)mg.Comparability between the 2 teams after remedy, morphine consumption of the radio frequency group decreased considerably than the management group, and the distinction was statistically vital (t=22.341, 16.758, 17.827, 15.541, all P<zero.05). In the course of the operation , no error occurred with needle penetrating the belly cavity, chest, offal or blood vessels. Conclusion: Ultrasound-guided spinal nerve posterior ramus pulsed radio frequency remedy of decrease again or anterior belly wall post-herpetic neuralgia proves efficient and might scale back affected person morphine utilization and result in fewer antagonistic reactions.

PMID: 29562396 [PubMed – in process]

The efficacy of ultrasound-guided spinal nerve posterior ramus pulsed radiofrequency treatment for aged lower back post-herpetic neuralgia | Migraine specialist london

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