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Radiofrequency denervation has been established for many years as an important minimally invasive procedure for the treatment of chronic pain conditions. Positive experiences of many users for various indications are contrasted by a nonuniform evidence. With meticulous patient selection and correct assessment of the indications a longer term reduction of pain, a reduced need for analgesics and an improvement in the quality of life can be achieved. The aim of this interdisciplinary position paper is to present the value of radiofrequency denervation in the treatment of chronic pain. The summarized recommendations of the expert group are based on the available evidence and on the clinical experiences of Austrian centers that frequently implement the procedure. The position paper contains recommendations on patient selection and proven indications. We discribe safety aspects, complications, side effects and contraindications.

Radiofrequency denervation has been established for many years as an important minimally invasive procedure for the treatment of chronic pain conditions. Positive experiences of many users for various indications are contrasted by a nonuniform evidence. With meticulous patient selection and correct assessment of the indications a longer term reduction of pain, a reduced need for analgesics and an improvement in the quality of life can be achieved. The aim of this interdisciplinary position paper is to present the value of radiofrequency denervation in the treatment of chronic pain. The summarized recommendations of the expert group are based on the available evidence and on the clinical experiences of Austrian centers that frequently implement the procedure. The position paper contains recommendations on patient selection and proven indications. We discribe safety aspects, complications, side effects and contraindications.In der Therapie chronischer Schmerzzustände ist die Radiofrequenzdenervierung seit Jahren als wichtiges minimal-invasives Verfahren etabliert. Positiven Erfahrungen zahlreicher Anwenderinnen und Anwender in unterschiedlichen Indikationen steht eine nicht einheitliche Evidenzlage gegenüber. Bei sorgfältiger Patientenselektion und korrekter Indikationsstellung können damit eine längerfristige Schmerzreduktion, ein reduzierter Analgetikabedarf und eine Verbesserung der Lebensqualität erreicht werden. Ziel dieses interdisziplinären Positionspapiers ist es, den Stellenwert der Radiofrequenzdenervierung in der Therapie chronischer Schmerzen darzustellen. Die zusammenfassenden Empfehlungen der Expertengruppe basieren auf verfügbarer Evidenz ebenso wie auf den klinischen Erfahrungen österreichischer Zentren, die das Verfahren häufig einsetzen. Das Positionspapier enthält Empfehlungen zur Patientenselektion und zu bewährten Indikationen. Sicherheitsaspekte, Komplikationen, Nebenwirkungen und Kontraindikationen werden beschrieben.

Experiences with long-term intraspinal infusion of opioid drugs using the new implantable medication pump VIP 30 in patients with chronic non-malignant pain are reported. During a 19-month period 10 patients with chronic pain - mainly mixed nociceptive-neuropathic pain -underwent implantation of the medication pump for long-term treatment. The mean follow-up period was 9.5 months. Pain relief was classified as very good in 22.2 %, good in 44.4 %, moderate in 22.2% and poor in 11. 1%. In 88.9% of the cases the patients stated they would undergo the same procedure again. Technical problems (catheter dislocation) developed in 1/10 patients could be surgically corrected. One pump including catheter was explanted because of an infected seroma within the pocket area. Long-term intrathecal application of opioids with the VIP 30 pumps is an effective and safe treatment in patients with chronic non-malignant pain.