Comparative Analysis Between Radiofrequency Ablation Techniques and Ultrasound-Guided Nerve Blocks in the Treatment of Postherpetic Neuralgia
Authors: Barros Armando Lira , Sentinella Maurício Aparecido Terrani , Alencar Marília Gabriela Mendes de , Oliva Tatiane Zandoná , Silva Milena Moreira Dias , Rodrigues Wendell Erllen Remigio de Souza , Souza Patrícia Pereira Santana , Cavalcanti Dulce Cerqueira Ferreira , Arruda Fábio Ivo de Freitas , Farias Anna Carolyne Barbosa , Moura Heloise Gabriella Queiroz , Brito Artur Freire , Saldanha Luciano Victor Vasconcelos , Ribeiro Thanisy Freitas , Fonseca Érika Lorrayne Ferreira , Fonseca Kerolaine Silva , Siqueira Itala Viviane Patriota de , Carvalho Camila Maria Bertão , Cavalcante Yago Mendonça Alves , Araújo Ana Leticia de Moraes , Santana Lorena Neves , Lopes Andara Teixeira Bezerra , Cabral Rayanne Orellana Pereira , Laureano Elizabeth Suassuna , Torres Tullazy Cavalcante , Silva Ana Kallynne de Araújo , Leite Laryssa Batista Pedreira 
Published: February 2025

Objective: This study aims to systematically and quantitatively analyze the outcomes of radiofrequency ablation (RFA) and ultrasound-guided nerve blocks (USNB) in the treatment of postherpetic neuralgia (PHN), focusing on their efficacy, safety, and impact on pain relief and quality of life.
 
Theoretical Framework: Postherpetic neuralgia is a common and debilitating complication of herpes zoster infection, characterized by persistent neuropathic pain that significantly affects patients' daily activities and mental well-being. Conventional pharmacological treatments often fail to provide adequate relief and are associated with undesirable side effects, necessitating the exploration of alternative interventional approaches. RFA and USNB have emerged as promising minimally invasive techniques that offer targeted pain relief with fewer systemic side effects. RFA provides prolonged pain relief by modulating nociceptive pathways, while USNB offers immediate, though temporary, pain relief by delivering anesthetic agents directly to the affected nerves.
 
Method: A systematic review was conducted using the PubMed, Scopus, and Web of Science databases to identify relevant studies published between 2018 and 2025. The inclusion criteria focused on studies analyzing pain reduction, functional outcomes, recurrence rates, and complication profiles in PHN patients treated with RFA and USNB. Exclusion criteria eliminated studies without interventional treatments, lacking relevant outcome measures, or published in languages other than English.
 
Results and Discussion: The review findings suggest that RFA provides more prolonged pain relief compared to USNB, with lower recurrence rates and reduced dependency on pharmacological management. However, USNB offers quicker pain relief and fewer procedural risks, making it an attractive option for immediate symptom control. Both techniques have demonstrated favorable safety profiles, though variations in patient selection and procedural execution may influence outcomes. Comparative studies indicate that a multimodal approach combining both techniques may provide optimal management for PHN.
 
Research Implications: This study highlights the need for further large-scale, multicenter trials to establish standardized treatment protocols and assess long-term outcomes of RFA and USNB in PHN management. Future research should also focus on cost-effectiveness, patient-reported outcomes, and personalized treatment strategies to enhance clinical decision-making.
 
Originality/Value: This systematic review provides valuable insights into the comparative effectiveness of RFA and USNB in PHN management, offering evidence to support informed clinical decision-making and improve patient outcomes. The findings contribute to the evolving landscape of interventional pain management and underscore the importance of individualized treatment strategies for PHN patients.