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Review
. 2024 Mar 4:17:851-863.
doi: 10.2147/JPR.S439909. eCollection 2024.

Efficacy and Safety of High-Voltage Pulsed Radiofrequency versus Standard-Voltage Pulsed Radiofrequency for Patients with Neuropathic Pain: A Literature Review and Meta-Analysis

Yu Wang  1   2 , Yitong Jia  3 , Zheng Wang  4 , Guang Feng  3 , Yanhui Ma  3 , Zhen Fan  3 , Miao Liu  3 , Kunpeng Feng  3 , Tianlong Wang  3
Affiliations
Review

Efficacy and Safety of High-Voltage Pulsed Radiofrequency versus Standard-Voltage Pulsed Radiofrequency for Patients with Neuropathic Pain: A Literature Review and Meta-Analysis

Yu Wang et al. J Pain Res. .

Abstract

Background: Neuropathic pain (NP) is recognized as one of the most difficult pain syndromes which lacks a safe, well-tolerated and effective treatment. Pulsed radiofrequency (PRF), a novel and minimally invasive interventions, has been introduced to alleviate various types of NP. Previous studies reported PRF with higher voltage could further improve the treatment efficacy. Therefore, we conducted this systematic review and meta-analysis to determine whether high-voltage PRF is superior to standard-voltage PRF for the treatment of NP patients.

Methods: Databases published from the date of inception until 15 March 2022 on PubMed/MEDLINE, EMBASE, Web of Science and the Cochrane Library were searched for RCTs comparing high-voltage PRF and standard-voltage PRF in NP patients. The primary outcome measures were the efficiency rates of NP patients with high-voltage PRF or standard-voltage PRF treatment. Data analysis was conducted using the Review Manager software (RevMan V.5.3).

Results: Six RCTs involving 423 patients were included in our meta-analysis. Compared with standard-voltage PRF group, the high-voltage PRF group attained a higher efficiency rate at 1 month (P = 0.04; I2 = 0%), 3 months (P = 0.04; I2 = 0%), 6 months (P = 0.002; I2 = 0%) post-procedure respectively. There was no significant difference in the complications between the two groups.

Conclusion: Our study supported that high-voltage PRF attained more satisfactory efficacy than standard-voltage PRF without increased side effects. High-voltage PRF could be a promising, effective, minimally invasive technology for NP patients.

Keywords: efficacy; high-voltage; pulsed radiofrequency; standard-voltage; trigeminal neuralgia.

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Conflict of interest statement

The authors declare that they have no competing interest in this work.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
(A) The effective rate at 1 month post-procedure; (B) The effective rate at 3 months post-procedure; (C) The effective rate at 6 months post-procedure; (D) The effective rate at 1 year post-procedure.
Figure 3
Figure 3
(A) The NRS or VAS score at 3 days post-procedure; (B) The NRS or VAS score at 1 week post-procedure; (C) The NRS or VAS score at 2 weeks post-procedure; (D) The NRS or VAS score at 1 month post-procedure; (E) The NRS or VAS score at 3 months post-procedure; (F) The NRS or VAS score at 6 months post-procedure.
Figure 4
Figure 4
(A) The PCS score at 1 week post-procedure; (B) The PCS score at 1 month post-procedure; (C) The PCS score at 3 months post-procedure; (D) The PCS score at 6 months post-procedure.
Figure 5
Figure 5
(A) The MCS score at 1 week post-procedure; (B) The MCS score at 1 month post-procedure; (C) The MCS score at 3 months post-procedure; (D) The MCS score at 6 months post-procedure.
Figure 6
Figure 6
(A) The occurrence rate of bradycardia; (B) The occurrence rate of tachycardia; (C) The occurrence rate of numbness; (D) The occurrence rate of swelling; (E) The occurrence rate of worsened pain; (F) The occurrence rate of ocular anesthesia; (G) The occurrence rate of corneal abrasions.
Figure 7
Figure 7
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies.
Figure 8
Figure 8
Risk of bias summary: review authors’ judgements about each risk of bias item for each included study (Green symbols represented low risk, red symbols represented high risk, and yellow symbols represented unclear risk).
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