Intercostal nerve radiofrequency coagulation treatment for postherpetic neuralgia：clinical observation of 20 cases / 介入放射学杂志

ABSTRACT

Objective To evaluate the efficacy of fluoroscopy-guided intercostal nerve radiofrequency coagulation in treating postherpetic neuralgia. Methods A total of 40 patients with postherpetic neuralgia (VAS ≥ 4.0) were randomly and equally divided into two groups. Patients in group A (control group) were treated with gabapentin, amitriptyline and oxycodone, while patients in group B (study group) were treated with intercostal nerve radiofrequency coagulation together with the same medicines used in group A. VAS score and oxycodone dosage were determined before the treatment and one, 7, 30, 90 and 180 days after the treatment. The side effects and complications during the treatment were recorded. The results were analyzed and compared between the two groups. Results The VAS scores of patients in group A and group B before the treatment and one, 7, 30, 90 and 180 days after the treatment were (8.2 ± 1.6) vs (8.1 ± 1.1), (6.1 ± 1.7) vs (4.5 ± 1.2), (4.2 ± 1.4) vs (2.7 ± 1.4), (3.6 ± 1.1) vs (2.3 ± 1.3), (3.3 ± 1.3) vs (1.6 ± 0.9), and (2.7 ± 1.2) vs (1.3 ± 1.0), respectively (P<0.05 in all), while the oxycodone dosages in group A and group B were (28.5 ± 5.4) mg vs (28.7 ± 5.8) mg, (35.2 ± 8.5) mg vs (17.3 ± 5.4) mg, (1.6 ± 8.5) mg vs (12.3 ± 3.8) mg, (18.6 ± 4.4) mg vs (5.1 ± 1.7) mg, (10.4 ± 2.3) mg vs (5.6 ± 1.1) mg, and (8.4 ± 1.6)mg vs (4.0 ± 1.1)mg, respectively (P < 0.05 in all). The drug side effects in group B were obviously very mild, and no serious complications occurred. Conclusion Fluoroscopy-guided intercostal nerve radiofrequency coagulation can rapidly relieve the pain in patients with postherpetic neuralgia, and reduce the oxycodone dosage and the occurrence of drug-related side effects as well. Therefore this technique is a safe and effective method for postherpetic neuralgia.