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Objective To investigate the clinical efficacy of CT-guided pulsed radiofrequency combined with continuous nerve block in the treatment of refractory postherpetic neuralgia(PHN).Methods A total of 208 patients with refractory PHN,who were admitted to the Hengshui Municipal People's Hospital of China between January 2021 and January 2023,were selected as the subjects of study.Using random number table method,the patients were divided into combination group and control group,with 104 patients in each group.The patients of control group received CT-guided pulsed radiofrequency therapy,and the patients of combination group received additional continuous nerve block therapy on the basis of the treatment of control group.The pain degree at different time point,clinical effective rate,number of analgesia remedy times,quality of sleep,and the levels of serum high mobility group box 1(HMGB1),interleukin-1 β(IL-1β)and interleukin-10(IL-10)were compared between the two groups.Results During the follow-up period,4 patients were lost in touch.Finally,103 patients were included in the combination group and 101 patients were included in the control group.The total treatment response rate in the combination group was 89.32％,which was significantly higher than 78.22％in the control group(P＜0.05).There were statistically significant differences in visual analogue scale(V AS)scores and Athens insomnia scale(AIS)scores including the time effect,inter-group effect and time-group interaction effect,between the two groups(P＜0.05).The postoperative one-week,2-week,4-week VAS scores and AIS scores in the combination group were remarkably lower than those in the control group(P＜0.05).The number of analgesia remedy times in the combination group was smaller than that in the control group,and the used dosage of tramadol in the combination group was lower than that in the control group(P＜0.05).Four weeks after treatment,the serum levels of HMGB1,IL-1β and IL-10 in the combination group were lower than those in the control group(P＜0.05).Conclusion For the treatment of refractory PHN,CT-guided pulsed radiofrequency combined with continuous nerve block can effectively alleviate neural inflammatory damage,and improve pain symptoms and sleep quality,besides,its analgesic effect and clinical efficacy are superior to CT-guided pulsed radiofrequency alone.(J Intervent Radiol,2024,33:264-268)
RESUMEN
Objective To study the clinical effect of biofeedback stimulation combined with hypogastric plexus blocking on chronic pelvic pain.Methods Sixty of patients with chronic pelvic pain(CPP)were randomly divided into the biofeedback stimulation group(BF group,n = 20),the continuous abdominal block group(NB group,n = 20)and the combination group(BF-NB Group,n = 20). The BF group was treated with biofeedback electrical stimulation for 2 months,while the NB group was treated with continuous hypogastric plexus blocking for 2 weeks and the BF-NB group was pre-treated with 2 weeks of hypogastric plexus blocking and then underwent biofeedback electrical stimulation for 2 months. We recorded the visual analogue scale(VAS)scores before treatment,2,4,8 weeks and 3 months after the treatment and adverse events.Results The VAS scores of the BF-NB group at 2,4,8 weeks and 3 months after treatment were significantly lower than those before treatment and the other groups(P<0.05).The significantly effective rate and total effective rate of the BF-NB group were signifi-cantly higher than those before treatment of the BF group and the NB group(P < 0.05). There was no significant difference in rate of adverse events between the BF-NB group and the NB group(P>0.05).Conclusion The bio-feedback electrical stimulation combined with the hypogastric plexus block is a safe and effective method to relieve chronic pelvic pain.