AI Article Synopsis
- This study examined the effectiveness and safety of early combined therapy using CT-guided paravertebral nerve blocks, pulsed radiofrequency, and subcutaneous injections for treating acute/subacute herpes zoster (shingles).
- A total of 98 patient records were reviewed, showing significant pain reduction after treatment, with effective rates of over 74% observed at multiple follow-up periods.
- Results indicated better outcomes for patients in the acute phase compared to those in the subacute phase, and no severe complications were reported, highlighting this approach as a promising treatment option for herpes zoster-related pain.
Article Abstract
Objectives: This retrospective study aimed to investigate the effectiveness and safety of early combined therapy with CT-guided paravertebral nerve (PVN), pulsed radiofrequency (PRF), and subcutaneous block on acute/subacute herpes zoster (HZ).
Methods: A total of 98 medical records were analyzed. All patients underwent CT-guided PRF on PVN immediately followed by a single subcutaneous block with lidocaine and dexamethasone in acute/subacute phase. The therapy efficacy was evaluated by pain numeric rating scale (NRS) and effective rate, which was defined as a percent of cases with a reduction in pain NRS>50% at day 1, week 2, 4, 12, and 24 after the procedure. The incidences of medication reduction and postherpetic neuralgia (PHN) were also retrieved. Further comparison was conducted between acute group (disease duration<30 days from HZ onset) and subacute group (30 day
Results: Early combined therapy indicated an immediate and sustained improvement in pain NRS as compared with before treatment ( P <0.0001), with effective rates of 74%, 79%, 80%, 76%, and 79% at day 1, week 2, 4, 12, and 24 after procedure, respectively. At the end of follow-up, the proportion of patients with a reduction of >50% in prior medications amounted to 83% and the incidence of clinically meaningful PHN decreased to 23%. The clinical efficacy was more profound in acute group than in subacute group at every time points ( P <0.05). No severe complications occurred.
Discussion: Our data revealed surprising levels of pain relief by combination therapies of PRF and subcutaneous block targeting different sites of pain pathway, thus suggesting a valuable treatment option for acute/subacute herpetic neuralgia.
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| http://dx.doi.org/10.1097/AJP.0000000000001202 | DOI Listing |
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