Different Pulsed Radiofrequency Modes on Gasserian Ganglion Improved Acute/subacute Zoster-related Trigeminal neuralgia: A Randomized, Double-Blinded, Controlled Trial

Abstract Background: Trigeminal postherpetic neuralgia (PHN), developed from herpes zoster virus infected on gasserian ganglion, is a severe neuropathic pain and often refractory to existing treatment. Pulsed radiofrequency (PRF) is known to be effective for treating acute/subacute zoster-related pain, but the effectiveness of different PRF mode has not been tested.Objective: This study aimed to investigate the efficacy and safety of different PRF modes on gasserian ganglion in patients with acute/subacute zoster-related trigeminal neuralgia.Methods: 120 patients were equally randomized into 2 groups (n = 60): high-voltage, long-duration PRF(HL-PRF) group and standard PRF(S-PRF) group. One cycle high-voltage, long-duration PRF was applied in HL-PRF group and three cycles standard PRF were performed in S-PRF group. Visual analog scales (VAS), 36-item short form health survey scores (SF-36) and average doses of pregabalin were recorded at different time points. Results: There were significant declined in VAS and SF-36 scores in both two groups at different time point after PRF treatment (P < 0.001). The scores of VAS and SF-36 in HL-PRF group were significantly lower than those in S-PRF group at different time points after treatment (P < 0.05). The dosages of pregabalin were also lower in HL-PRF group at days 3, 14 and 28 after treatment (P < 0.05). There was no serious adverse effect in either group. Conclusion: High-voltage, long-duration PRF on gasserian ganglion is more effective than standard PRF for acute/subacute zoster-related trigeminal neuralgia patients. Clinical Trial Registration: ChiCTR2000038775