Background and Aims Post-herpetic neuralgia is a persistent pain condition that occurs after an acute vesicular rash of herpes zoster heals1.The intense and disabling pain affect the patient‘s quality of life, his quality of sleep and his ability to perform daily activities.
This report describes a treatment case of postherpetic neuralgia with ultrasound-guided PRF.
Methods The case was a 56-year-old woman with a two-month history of continuous pain and burning in the anterior and left thoracic region, left arm. At her first visit, the VAS was 10/10.The patient was in lateral decubitus position on the operating table with slight hyperextension of the neck (figure 1). After preparation of the neck region, a sterile linear probe was placed transversely on the medial edge of the sternocleidomastoid muscle. In this position the body and the transverse process of C6 were identified. The probe was slid caudally to identify the transverse process of C7. Under constant ultrasound guidance and fluoroscopy, a 22 G 100 mm radiofrequency needle was introduced and advanced until it reached the anterior margin of the lungus colli muscle (figure 2). Subsequently, a thermocouple connected to a radiofrequency generator was inserted to reproduce the patient‘s paresthesia via sensitive stimulation (50 HZ), 0.7–0.9 mV. The pulsed radiofrequency treatment was performed with 1200 pulses at 42°C.
Conclusions However, further studies would be needed to assess whether the proposed technique could be considered a valid therapeutic tool for pain control.
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