Efficacy of Ultrasound-Guided Transverse Abdominal Plane Block for Residual Pain After Pulsed Radiofrequency in Abdominal Acute/Subacute Herpes Zoster-Related Pain.

Abstract

Background: Pulse radiofrequency (PRF) can reduce the persistent pain of herpes zoster (HZ), but some patients still have residual pain and do not achieve satisfactory results. This study aimed to assess the efficacy of PRF combined with transverse abdominal plane (TAP) block for abdominal acute/subacute HZ-related pain.

Methods: A total of 137 acute/sub-acute HZ patients with successful PRF treatment were recruited from the Pain Department of Wuhan No. 1 Hospital between January 2018 and January 2020. There were two groups: the transversus abdominis plane group (TAP group, n = 64) and the normal saline group (NS group, n = 60). Pain intensity, sleep quality, and quality of life were quantified using the visual analogue scale (VAS), the five-item questionnaire and scoring system, and the 36-item Short Form Health Survey (SF-36) questionnaire, respectively. Follow-up assessments were conducted at baseline, 1 day, 3 months, 6 months, and 12 months after the block therapy.

Results: Compared to the NS group, the TAP group showed significantly decreased pain scores 1 day, 3 months, 6 months, and 12 months after block therapy (P < .05). The sleep quality scores were lower in the TAP group than that in the NS group at 6 months (5.0 ± 2.4 vs 6.3 ± 3.7, p = .042), and 12 months after therapy (3.1 ± 1.8 vs 4.1 ± 2.4, p = .031). For quality of life, in comparison to NS group participants, those in the TAP group exhibited significantly higher scores (p < .05) for quality of life at 3 months, 6 months, and 12 months follow-up. There was a significant decrease in the proportion of pregabalin and analgesic medications in the TAP group and NS group at 6 and 12 months after treatment compared to Baseline (p < .001). Furthermore, the results showed that there was a significant difference in VAS, sleep quality scores (SQS), and quality of life between the PRF + TAP group and pharmacological therapies group before and 12 months after treatment (p < .05).

Conclusion: The TAP block is a promising complementary treatment for acute/subacute HZ patients who have undergone PRF treatment. Combining PRF with the TAP block has the potential to alleviate HZ-related pain, enhance the patients' quality of life, and improve their sleep quality.