Efficacy of pulsed radiofrequency with stellate ganglion block therapy for neuralgia

Application of high-voltage pulsed radiofrequency with stellate ganglion block delivers a safe, effective, and environmentally friendly option for acute conditions, improving sleep, relieving anxiety, and lowering postherpetic neuralgia risk.

To study the clinical effectiveness of combining high-voltage long-duration pulsed radiofrequency (PRF) with stellate ganglion block (SGB) for acute thoracic and dorsal herpes zoster neuralgia, using dual guidance of ultrasound and C-arm to address the challenges where single therapies may fall short.

Seventy-nine patients with acute zoster neuralgia (AZN) were studied and categorized based on three treatment approaches used:

• Group S used standard voltage PRF
• Group H used high-voltage long-duration PRF and
• Group C used high-voltage long-duration PRF combined with SGB.

The study outcomes were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Rating Scale (HAMA) and the Numeric Rating Scale (NRS) with the incidence of postherpetic neuralgia following treatment also being recorded.

Post-treatment, the scores of NRS, PSQI, and HAMA improved from baseline in all groups, with the most noteworthy improvement observed in group C compared to group S. Group C also exhibited lower consumption of Tramadol and Pregabalin, along with decreased interleukin-6 and galectin-3 plasma levels compared to group S. Further, the incidence of postherpetic neuralgia was notably lower in group C than in group S. 

A combination of long-duration PRF at high voltage alongside SGB, guided by ultrasound and C-arm, offers a safe and efficacious technique for treating AZN.