Clinical Efficacy of Pulsed Radiofrequency Combined with Intravenous Lidocaine Infusion in the Treatment of Subacute Herpes Zoster Neuralgia

医学 可视模拟标度 麻醉 利多卡因 脉动式射频电磁波 止痛药 生理盐水 外科 疼痛量表 神经痛 神经病理性疼痛 止痛
作者
Wanyun Zhang,Chunjing He
出处
期刊:Pain Research & Management [Hindawi Limited]
卷期号:2022: 1-14 被引量:7
标识
DOI:10.1155/2022/5299753
摘要

Objective. Under the guidance of a digital subtraction angiography (DSA) machine, via fluoroscopic imaging techniques, patients diagnosed with herpes zoster neuralgia at the subacute stage, where self-reported pain lasts between 30 and 90 days, were treated with nerve pulsed radiofrequency surgery combined with intravenous lidocaine infusion or saline infusion as control. This study explores the clinical efficacy, safety, and clinical value of the combined treatment compared with nerve pulsed radiofrequency surgery alone. Methods. In this study, 72 patients diagnosed with herpes zoster neuralgia at the subacute stage were randomly divided into two groups with matched gender, age, and clinical symptoms. Both groups received pulsed radiofrequency surgery for the affected nerve segments under DSA fluoroscopy. Five days after the operation, 0.9% saline was administered daily for five consecutive days (50 ml per day, intravenous infusion) to group A (n = 36), and lidocaine was administered daily for five consecutive days (3 mg per kg per day, intravenous infusion) to group B (n = 36). Patients with poor pain control during the treatment were given 10 mg morphine tablets for pain relief to reach visual analog scale (VAS) ≤4 points. Data of the following categories were collected: VAS score, self-rating anxiety scale (SAS) score, depression self-rating scale (SDS) score, Pittsburgh sleep quality score (PSQI), 45 body area rating scale score, skin temperature measurement using infrared thermography, analgesic drug use before and after treatment at six different time points: before surgery (T0), one day after surgery (T1), three days after surgery (T2), five days after surgery (T3), one month after surgery (T4), and two months after surgery (T5). Blood was collected from all patients in the morning before surgery and right after the last intravenous infusion of lidocaine at T3. Serum inflammatory indexes including white blood cell count, lymphocyte count, neutrophils count, erythrocyte sedimentation rate count, C-reactive protein (CRP) level, calcitonin gene-related peptide (CGRP) level, and interleukin-6(IL-6) level were determined. Lastly, the incidence of complications and adverse reactions throughout the study was recorded. Results. In total, 64 out of 72 patients completed the whole study. Two patients met the exclusion criteria in group A, one patient refused to participate, and one was lost to follow-up. Two patients met the exclusion criteria in group B, and two were lost to follow-up. Three patients in group B experienced vomiting during lidocaine treatment. The adverse symptom was relieved after symptomatic treatment. No patients in the two groups had severe complications such as hematoma at the puncture site, pneumothorax, and nerve injury. Compared with before treatment, the mean of VAS score, SAS score, SDS score, PSQI score, and skin temperature of both groups at each time point after interventional surgery were all significantly reduced. Furthermore, at each time point after surgery, the above indicators of group B patients were significantly lower than those of group A patients. After treatment, the consumption of analgesics in both groups was significantly lower than before treatment. Compared with group A, the consumption of analgesics was also significantly lower in group B. In addition, serum inflammatory indexes at the T3 time point of the two groups of patients were lower than T0. Among them, the erythrocyte sedimentation rate, CRP level, CGRP level, and interleukin-6 level of group B were significantly lower than those of group A. The incidence of postherpetic neuralgia (PHN) in group B patients (6.25%) was also lower than that in group A patients (25%). Conclusion. DSA-guided nerve pulse radiofrequency surgery combined with intravenous lidocaine infusion can effectively relieve pain in patients diagnosed with herpes zoster nerves at the subacute stage, reduce the number of analgesic drugs used in patients, reduce postherpetic neuralgia incidence rate, and improve sleep and quality of life.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
顺利的飞荷完成签到,获得积分0
1秒前
斯文败类应助qyliu采纳,获得10
1秒前
Jasper应助好事发生采纳,获得10
2秒前
2秒前
2秒前
3秒前
852应助在远方采纳,获得10
3秒前
Z趋势完成签到,获得积分10
4秒前
Lucia发布了新的文献求助10
4秒前
4秒前
4秒前
研友_VZG7GZ应助txt0127采纳,获得10
4秒前
5秒前
wdy337完成签到,获得积分10
5秒前
8秒前
浙西南呱呱完成签到,获得积分10
9秒前
9秒前
9秒前
黄道婆发布了新的文献求助10
10秒前
苦木完成签到,获得积分10
11秒前
阔达的宝莹完成签到,获得积分20
12秒前
艾米发布了新的文献求助20
13秒前
14秒前
14秒前
14秒前
没有名字行不行完成签到,获得积分10
14秒前
呆萌芙蓉发布了新的文献求助10
14秒前
著有炖粉条完成签到,获得积分10
15秒前
15秒前
在远方发布了新的文献求助10
16秒前
17秒前
万能图书馆应助黄道婆采纳,获得20
17秒前
hou完成签到,获得积分10
19秒前
米粒之珠亦放光华完成签到,获得积分20
19秒前
英俊的铭应助月亮采纳,获得10
19秒前
知甘完成签到,获得积分20
20秒前
cocolu应助张道微采纳,获得10
20秒前
儒雅沛凝发布了新的文献求助10
20秒前
阿宇发布了新的文献求助10
20秒前
Forest发布了新的文献求助10
21秒前
高分求助中
Solution Manual for Strategic Compensation A Human Resource Management Approach 1200
Natural History of Mantodea 螳螂的自然史 1000
Glucuronolactone Market Outlook Report: Industry Size, Competition, Trends and Growth Opportunities by Region, YoY Forecasts from 2024 to 2031 800
A Photographic Guide to Mantis of China 常见螳螂野外识别手册 800
Zeitschrift für Orient-Archäologie 500
Smith-Purcell Radiation 500
Autoregulatory progressive resistance exercise: linear versus a velocity-based flexible model 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 细胞生物学 免疫学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3343583
求助须知:如何正确求助?哪些是违规求助? 2970629
关于积分的说明 8644643
捐赠科研通 2650717
什么是DOI,文献DOI怎么找? 1451432
科研通“疑难数据库(出版商)”最低求助积分说明 672137
邀请新用户注册赠送积分活动 661569