The Clinical Investigation Of Different Voltage Bipolar Pulsed Radio Frequency For The Treatment Of Acute Zoster-associated Pain

Objectives:To compared the clinical efficacy and safety of different voltage bipolar pulsed radio frequency for the treatment of acute zoster-associated pain.Methods:A total of sixty adult patients in the acute herpes zoster,two pulsed radiofrequency trocars were carefully inserted until the needle tip reached the middle-upper edge of the intervertebral foramen with the computed tomography(CT)guidance,ensured the needle tip in close proximity to the dorsal root ganglion(DRG)by the sensation and exercise test,divided into the standard voltage group and the high voltage group randomly before starting bipolar pulsed radiofrequency.For the standard voltage group,the output voltage was 50 V,and for the high voltage group,the output voltage increased gradually until the maximum voltage(bearable without causing pain in conscious patients),the remaining parameters were pulse temperature of 42?and pulse duration of 20 ms and pulse rate of 2 Hz and pulse time of 480 s.Adjust the doses of gabapentin and combined with tramadol based on the patients' tolerance degree of pain.The therapeutic effects were evaluated using the PRI-S and PRI-A of the short-form of McGill pain questionnaire(SF-MPQ),numerical rating scale(NRS),present pain intensit(PPI),sleep quality(SQ),the weekly doses of gabapentin and the numbers of patients use tramadol before PRF and 1,2,3,4weeks after PRF,observed the sensation test voltage,resistance and out-voltage in PRF and the adverse reactions after PRF.Results:The general conditions were no significantly differences between the two groups.the sensation test voltage and resistance in PRF were also no significant differences between the two groups.There were significant decrease in the PRI-S?PRI-A?NRS?PPI and increase in the SQ in both groups at 1,2,3,and 4 weeks after PRF(P<0.05).However,this decrease was more significant in the high voltage PRF group than in the standard voltage PRF group.The PRF voltage was higher in the high voltage PRF group than in the standard voltage PRF group(P<0.05),the SQ was higher in the high voltage PRF group than in the standard voltage PRF group at 1 week after PRF(P<0.05),the weekly doses of gabapentin decreased significantly in the high voltage PRF group than in the standard voltage PRF group at 3 and 4 weeks after PRF(P<0.05).No adverse reactions were identified after PRF in two groups.Conclusion:Compared to the standard voltage group,the high voltage bipolar pulsed radiofrequency was effective and safe for the treatment of acute zoster-associated pain,decreased the doses of gabapentin,improved the quality of life,and no adverse reactions were occurred.