Efficacy of Gasserian Ganglion High‐Voltage, Long‐Duration Pulsed Radiofrequency Combined With Block on Acute/Subacute Zoster‐Related Trigeminal Neuralgia

Background: Trigeminal postherpetic neuralgia (TPHN) is a severe chronic pain that can lead to various socioeconomic consequences. Therefore, it is necessary to explore optimal treatment options for acute/subacute herpes zoster (HZ)–related trigeminal neuralgia and prevent the further development of TPHN. High‐voltage, long‐duration pulsed radiofrequency (HL‐PRF) of the Gasserian ganglion is a new surgical intervention used to treat PHN. A ganglion block has been reported to possess anti‐inflammatory effects and potential analgesic benefits. Methods: We included 83 patients with HZ‐related acute/subacute trigeminal neuralgia admitted from January 1, 2021, to June 1, 2023, and received Gasserian ganglion HL‐PRF combined with block. A 6‐month follow‐up was conducted, including Numerical Rating Scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), the incidence of TPHN, the dosage of anticonvulsants and analgesics, efficacy, and adverse events. Results: All patients showed a significant decrease in postoperative NRS scores ( p < 0.05). The NRS scores of the acute HZ group were consistently lower than those of the subacute HZ group at different time points ( p < 0.01). The overall incidence of TPHN from the onset of HZ to 12 weeks is 21.68%. The incidence of TPHN in the acute phase group was 12.77%, significantly lower than the 33.33% in the subacute phase group ( p = 0.024). The effective rate was 74.7% in all patients, at 3 months after the treatment. The effective rate was 82.98% in the acute phase group and 63.89% in the subacute phase group, showing a statistically significant difference ( p = 0.047). The PSQI score of the acute group was consistently lower than that of the subacute group ( p < 0.01). The dosage of analgesics and anticonvulsants used in the acute HZ group was lower than that in the subacute group ( p < 0.01). All patients did not experience serious adverse reactions. Conclusions: Gasserian ganglion HL‐PRF combined with block can be an effective and safe technique to relieve the pain of acute/subacute zoster‐related trigeminal neuralgia and prevent the incidence of TPHN.