Observation on effect of pulsed radiofrequency combined with intravenous drip of lidocaine in treatment of acute herpetic neuralgia

CHANG Xindong; TANG Ming; WANG Yiwen; QIAN Chenhuiyu; PAN Shengquan; YIN Shiwu

doi:10.3969/j.issn.1674-3806.2025.05.14

Abstract：Objective To observe the effect of pulsed radiofrequency(PRF)combined with intravenous drip of lidocaine in treatment of acute herpetic neuralgia(AHN).Methods A total of 60 patients with AHN who were admitted to Department of Interventional Vascular Pain Management,the Second People's Hospital of Hefei Affiliated to Wannan Medical College from April 2023 to June 2024 were recruited.The patients were divided into observation group and control group by using random number table method,with 30 cases in each group.The observation group received PRF combined with intravenous drip of lidocaine(once a day for 7 days),while the control group received PRF combined with intravenous drip of normal saline treatment.The patients were given tramadol sustained-release tablets orally,100 mg each time,once every 12 hours.If the patients' pain levels were reduced to mild pain,the dose of oral tramadol sustained-release tablets was changed to 50 mg each time,once every 12 hours.When the patients' Visual Analogue Scale(VAS)scores were less than 3 points,the oral tramadol sustained-release tablets were discontinued.The VAS scores,Hospital Anxiety and Depression Scale(HADS)scores[including Hospital Anxiety Scale(HA)scores and Hospital Depression Scale(HD)scores]and Pittsburgh Sleep Quality Index(PSQI)scores were compared between the two groups at admission(T0),3 days after surgery(T,),1 week after surgery(T2),1 month after surgery(T3)and 3 months after surgery(T4).The dosage of tramadol during hospitalization(T0-T2 time points),postoperative adverse reactions and the occurrence of post-herpetic neuralgia(PHN)were compared between the two groups.Results The postoperative VAS scores and PSQI scores showed a downward trend in the two groups(P＜0.05).The VAS scores of the observation group were significantly lower than those of the control group at the time points of T3 and T4(P＜0.05),and the PSQI scores of the observation group were lower than those of the control group at the time points of T1,T2,T3 and T4(P＜0.05).The HA scores and HD scores showed a downward trend in the two groups(P＜0.05),but there were no significant differences in the HA scores and HD scores between the two groups at each time point(P＞0.05).The dosage of tramadol in the observation group was significantly lower than that in the control group during hospitalization(P＜0.05).There was no significant difference in the cumulative incidence of PHN between the two groups at the time point of T3(P＞0.05),while the cumulative incidence of PHN in the observation group was significantly lower than that in the control group at the time point of T4(P＜0.05).The total incidence of adverse reactions in the observation group was higher than that in the control group,but the difference was not statistically significant(26.67％vs 10.00％;x2=2.783,P=0.095).Conclusion PRF combined with intravenous drip of lidocaine is safe and effective in treatment of AHN,and can reduce the risk for the occurrence of PHN.