Efficacy of Pulsed Radiofrequency in Herpetic Neuralgia: A Meta-Analysis of Randomized Controlled Trials

Abstract

Objectives: Herpes zoster and postherpetic neuralgia (PHN) are often refractory to current standard treatments and can reduce patients' quality of life (QoL). Pulsed radiofrequency (PRF) effectively controls intractable neurological pain. The aim of the study was to conduct a systematic review and meta-analysis to evaluate the efficacy of PRF in PHN management.

Materials and methods: We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) published up to October 2019. The primary outcomes were pain levels and rescue analgesia at different postintervention time intervals. The secondary outcomes were QoL and sleep quality.

Results: We reviewed 6 RCTs involving 420 patients. The meta-analysis revealed that the PRF group exhibited significantly lower pain scores in PHN than did the control group at 2 to 3 days (weighted mean differences [WMD]=-2.82; 95% confidence interval [CI]: -5.08 to -0.55), 1 week (WMD=-2.95; 95% CI: -4.53 to -1.37), 2 weeks (WMD=-3.17; 95% CI: -4.11 to -2.23), 4 weeks (WMD=-2.59; 95% CI: -3.40 to -1.79), 8 weeks (WMD=-3.02; 95% CI: -4.17 to -1.88), and 6 months (WMD=-1.94; 95% CI: -2.85 to -1.03). After intervention, QoL was significantly higher in the PRF group than in the control group. No major complications were reported.

Discussion: PRF safely and effectively reduced pain scores and improved QoL in patients with herpes zoster in the cervical to lumbosacral areas. PRF could be considered during refractory PHN treatment. Future studies require standardized PRF settings and outcome assessment tools, including physical and emotional function assessments.