Ultrasound-guided Bipolar High-voltage Pulsed Radiofrequency On The Cervical Sympathetic Chain For Treating Acute Herpes Zoster Neuralgia

Objective:This study aimed to determine the safety and clinical efficacy of Ultrasound-guided bipolar high-voltage pulsed radiofrequency treatment of the cervical sympathetic chain for acute herpes zoster neuralgia located in head,face,neck or upper limbs,and determine whether it can reduce the incidence of PHN.Methods:Sixty patients with acute herpes zoster located in head,neck or upper limb were randomly divided into two groups.Radiofrequency group(n=30)received Ultrasound-guided bipolar high-voltage pulsed radio-frequency treatment for the affected side C6 and C7 transverse process horizontal cervical sympathetic chain(42℃、1HZ、10ms、80-100V、900S).In the control group(n=30),radio-frequency needle tip was placed in the horizontal cervical sympathetic chain of C6 and C7 transverse process on the affected side under ultrasound guidance,but radio-frequency therapy was not performed.72 hours later,treatment was repeated once in each group.VAS score,PSQI score,SF-36 score,analgesic drug consumption,incidence of postherpetic neuralgia and complication statistics were applied 24 hours after the first treatment,24 hours after the second treatment,1 month and 3 month after the second treatment to evaluate the therapeutic effect and safety.Complications during treatment were recorded: infection,hemorrhage,spinal cord or nerve injury,vocal cord dysfunction,limb movement disorder,etc.Results:After treatment,the VAS score and PSQI total score of the two groups were significantly lower than before treatment,while the SF-36 total score was higher(P <0.05).Compared with the control group,VAS score,PSQI total score,intake of tramadol and gabapentin were lower in RF group at each time point after operation,while SF-36 total score increased more significantly(P < 0.05).No related complications were observed.Conelusion:Ultrasound-guided bipolar high-voltage pulsed radio-frequency treatment of the cervical sympathetic chain can effectively relieve acute herpes zoster neuralgia in head,face,neck and upper limb and reduce the incidence of postherpetic neuralgia.