Post Herpetic Neuralgia (PHN) – Repeat Case – Pulse Radiofrequency (PRF) To Dorsal Root Ganglion Again Works

Case T7 PHN helped by PRF to dorsal root ganglion

Pulse Radiofrequency Ablation for a Case of Postherpetic Neuralgia
Brent Yeung, Netsere Tesfayohannes
41st Annual Regional Anesthesiology and Acute Pain Medicine Meeting
Thursday, March 31, 2016–Saturday, April 2, 2016 Abstract: 1236

  • 58 year old lady with t7 pain
  • pain 9/10

Unresponsive to:

  • trial of multiple opioids,
  • corticosteroid taper,
  • gabapentin/pregabalin,
  • duloxetine,
  • amytriptyline,
  • multi compound pain creams, and lidocaine patch

 

  • thoracic transforaminal blocks with lidocaine and dexamethasone – incomplete relief
  • pulse radiofrequency ablation of the T7-T8 dorsal root ganglion
  • 42 degrees for 120 seconds at the T7 and T8 level – without needing repeats
  • got 80% relief, depression remitted and she went back to work
  • still fine 6 months later

Comment – when pain is severe, most drug measures have little effect. Indeed, in neuropathic pain, response to meds is seen in only 23.7% ( I have wrote  about that  prior) cases.  I would do semineurolytic lidocaine 5% injections repeatedly to numb the intercostal nerve levels, and inject local steroid into tissues,  but obviously pulse radiofrequency bested that.

This had been done before:
Effect of pulsed radiofrequency for postherpetic neuralgia
Y. H. Kim, C. J. Lee, S. C. Lee, J. Huh, F. S. Nahm, H. Z. Kim, M. K. Lee
Acta Anaesthesiologica Scandinavica Volume 52, Issue 8, pages 1140–1143, September 2008
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2008.01752.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

I have discussed other options here:

http://painmuse.org/?cat=46

 

  golden goose golden goose

This entry was posted in post herpetic neuralgia. Bookmark the permalink.

Leave a Reply

Your email address will not be published.