Search

Abstract Study objective Advanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectiveness and safety of conventional radiofrequency (CRF) and high-voltage long-term pulsed radiofrequency (H-PRF) of radiofrequency therapy in the management of perineal pain in advanced rectal cancer. Design Randomized, Double-Blind Controlled Trial. Setting Sichuan Cancer Hospital & Institute and Yanjiang District People’s Hospital in Sichuan, China. Participants A total of 72 patients with advanced rectal cancer experiencing perineal pain who were accepted for radiofrequency treatment. Interventions Patients were assigned randomly (1:1) assigned to either the group CRF or H-PRF in a double-blind trial. Measurements and main results The primary focus was on assessing perineal pain using numeric rating scales (NRS) scores at various time points. Secondary outcomes included the duration of maintaining a sitting position, depression scores, sleep quality, consumption of Oral Morphine Equivalent and Pregabalin, and the incidence of perineal numbness. A total of 57 patients (28 patients in the group CRF and 29 patients in the group H-PRF) were investigated. At all observation time points postoperatively, both groups of patients exhibited significant reductions in pain, enhancements in depression, improvements in sleep quality, and increased duration of sitting compared to their baseline measurements (P 0.05). Conclusion Our results demonstrate that application of CRF and H-PRF in ganglion impar to reduce perineal pain and improve the quality of life of patients with advanced rectal cancer is safe and effective. However, the long-term effect of CRF is better compared with that of H-PRF. Trial registration https://www.chictr.org.cn/ (ChiCTR2200061800) on 02/07/2022. This study adheres to CONSORT guidelines.

Study objective: Advanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectiveness and safety of conventional radiofrequency (CRF) and high-voltage long-term pulsed radiofrequency (H-PRF) of radiofrequency therapy in the management of perineal pain in advanced rectal cancer. Design: Randomized, Double-Blind Controlled Trial. Setting: Sichuan Cancer Hospital & Institute and Yanjiang District People's Hospital in Sichuan, China. Participants: A total of 72 patients with advanced rectal cancer experiencing perineal pain who were accepted for radiofrequency treatment. Interventions: Patients were assigned randomly (1:1) assigned to either the group CRF or H-PRF in a double-blind trial. Measurements and main results: The primary focus was on assessing perineal pain using numeric rating scales (NRS) scores at various time points. Secondary outcomes included the duration of maintaining a sitting position, depression scores, sleep quality, consumption of Oral Morphine Equivalent and Pregabalin, and the incidence of perineal numbness. A total of 57 patients (28 patients in the group CRF and 29 patients in the group H-PRF) were investigated. At all observation time points postoperatively, both groups of patients exhibited significant reductions in pain, enhancements in depression, improvements in sleep quality, and increased duration of sitting compared to their baseline measurements (P<0.05). During the 3 months and 6 months follow-up period, the group CRF exhibited significant reduction in pain, improvement in depression, sleep quality, and increased the time of keeping a sitting position compared with the group H-PRF (P<0.05). The consumption of oral morphine equivalent and Pregabalin as well as the incidence of perineal numbness were not significantly different between groups (P > 0.05). Conclusion: Our results demonstrate that application of CRF and H-PRF in ganglion impar to reduce perineal pain and improve the quality of life of patients with advanced rectal cancer is safe and effective. However, the long-term effect of CRF is better compared with that of H-PRF. Trial registration: https://www.chictr.org.cn/ (ChiCTR2200061800) on 02/07/2022. This study adheres to CONSORT guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical intervention. In these groups of patients, radiofrequency ablation (RFA) techniques are safe minimally invasive treatments and provide significant and durable pain relief. Thus, we aimed to formulate the Indian Society for the Study of Pain (ISSP) guidelines for the management of chronic pain syndromes with various RFA techniques. An in-depth literature review by experts in Pain Medicine practising in India, was used to produce 16 statements across 4 common chronic pain syndromes, including knee pain, headache and facial pain, lumbar facet joint pain, and sacroiliac joint pain. The quality of evidence was assessed with the Third US Preventive Service Task Force guidance document and the strength of the recommendation was determined by the Delphi consensus process. The level of evidence for most of the statements was I. Moreover, for most statements, the level of agreement between the experts was good (≥80% of the experts). The ISSP guidelines for the management of chronic pain syndromes are developed by experts in pain medicine. For most of the statements, the highest level of evidence was available and inter-expert agreement was good. However, further high-quality research is required to formulate more inclusive guidelines in this evolving pain medicine speciality. [ABSTRACT FROM AUTHOR]

Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical intervention. In these groups of patients, radiofrequency ablation (RFA) techniques are safe minimally invasive treatments and provide significant and durable pain relief. Thus, we aimed to formulate the Indian Society for the Study of Pain (ISSP) guidelines for the management of chronic pain syndromes with various RFA techniques. An in-depth literature review by experts in Pain Medicine practising in India, was used to produce 16 statements across 4 common chronic pain syndromes, including knee pain, headache and facial pain, lumbar facet joint pain, and sacroiliac joint pain. The quality of evidence was assessed with the Third US Preventive Service Task Force guidance document and the strength of the recommendation was determined by the Delphi consensus process. The level of evidence for most of the statements was I. Moreover, for most statements, the level of agreement between the experts was good (≥80% of the experts). The ISSP guidelines for the management of chronic pain syndromes are developed by experts in pain medicine. For most of the statements, the highest level of evidence was available and inter-expert agreement was good. However, further high-quality research is required to formulate more inclusive guidelines in this evolving pain medicine speciality.

Yuanyuan Ding,1 Hongxi Li,1 Peng Yao,1 Tao Hong,1 Rongjie Zhao,2 Guangyi Zhao3 1Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China; 2Class 5 of 2020 Session, Shenyang No. 20 High School, Shenyang, China; 3Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China Background: Sacroiliac joint pain (SIJP) is an important cause of low back pain and seriously affects the patients’ quality of life. Therefore, it is urgent to find effective treatment methods. Objective: To observe the efficacy of intra-articular (IA) conventional radiofrequency (CRF) and pulsed radiofrequency (PRF) treatment of Sacroiliac joint syndrome (SIJS) under computed tomography (CT) guidance. Study design: Retrospective comparative study. Setting: Shengjing Hospital of China Medical University. Patients and methods: Sixty-four patients with SIJS were enrolled in the Pain management. Patients were randomized into two groups: CRF (CRF group, n=32) and PRF (PRF group, n=32). At each observation time, the general condition, visual analog scale (VAS), the total efficiency rate, Oswestry disability index (ODI), and 36-item short-form health survey were followed up. Results: Compared to the pretreatment value, the VAS and the ODI decreased in both groups after treatment (P

Background: Idiopathic trigeminal neuralgia (TGN) is a chronic pain disorder causing unilateral, severe brief stabbing recurrent pain in the distribution of one or more branches of the trigeminal nerve. Conventional radiofrequency (CRF) and pulsed radiofrequency (PRF) are two types of minimally invasive treatment. CRF selectively ablates the part of ganglion to provide the relief, but it has been found to be associated with some side effects such as dysesthesia or sensory loss in 6%–28% and loss of corneal reflex in 3%–8% of patients. PRF is a comparatively newer modality which is a nondestructive and neuromodulatory method of delivering radiofrequency energy to the gasserian ganglion to produce a therapeutic effect. Aims: We aimed to compare the efficacy of CRF with long-duration, fixed voltage PRF in the treatment of idiopathic TGN. Setting: This study was conducted in a tertiary care center research institute. Study Design: This was a prospective randomized trial. Materials and Methods: Twenty-seven adult patients of TGN were included in the study and randomly allocated into two groups (CRF and PRF). All procedures were performed operation suite with C-arm fluoroscopic guidance. Both, pre- and postprocedure, the patients were assessed for pain on the Visual Analog Scale (VAS) and Barrow Neurological Institute (BNI) Pain Intensity Scale at 1 week and thereafter at 1, 2, 3, and 6 months. Patients with a BNI score ≥4 after 1 month were considered a failure and offered other modes of treatment. A reduction in VAS score ≥50% and a BNI score <4 were considered as effective. Statistical Analysis: Discreet variables were recorded as proportions, ordinal variables and continuous variables with non-Gaussian distribution as medians with interquartile range, and continuous variables with Gaussian distribution as mean ± standard deviation. Association between ordinal variables was tested by Fisher's exact test/Chi-square test whenever appropriate. Equality of means/median was tested by using paired/unpaired t-test or nonparametric tests depending upon the distribution of data. P ≤ 0.5 was considered statistically significant. Data analysis was performed using STATA version 13.04 windows. Results: Efficacy in terms of decrease in VAS ≥50% at 1 month was 33.33% and 83.33% in the PRF and CRF groups, respectively, which was statistically significant(P = 0.036). Effective reduction in BNI scores at the 7th day, 1 month, and 2 months postprocedure was evaluated and found in 41.67% and 83.33% of patients in the PRF and CRF groups, respectively, which was statistically insignificant (P = 0.089). There was a statistically significant reduction in BNI scores in PRF and CRF group patients at 3 and 6 months (at 3 months, 33.33% and 83.33%, P = 0.036 and at 6 months, 25% and 83.33%, P = 0.012). In the CRF group, mild hypoesthesia was evident in three patients which improved by the end of 1 month while no side effects were seen in the PRF group. Conclusion: CRF is a more effective procedure to decrease pain in comparison to long-duration, fixed voltage PRF for the treatment of idiopathic TGN. Although the side effects are more with CRF, they are mild and self-limiting. Limitation: The limitations of this study were as follows: small sample size and short duration. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Chronic nononcological perineal pain has been effectively managed by ganglion Impar block. Chemical neurolysis, cryoablation, and radiofrequency ablation have been the accepted methods of blockade. Recently, pulsed radiofrequency, a novel variant of conventional radiofrequency, has been used for this purpose. Study Design This was a prospective, randomized, double-blind study. Setting Two different interventional pain management centers in India. Objective To compare the efficacy of conventional radiofrequency and pulsed radiofrequency for gangliom Impar block. Methods The patients were randomly allocated to one of two groups. In the conventional radiofrequency (CRF) group (N = 34), conventional radiofrequency ablation was done, and in the PRF pulsed radiofrequency (PRF) group (N = 31), pulsed radiofrequency ablation was done. After informed and written consent, fluoroscopy-guided ganglion Impar block was performed through the first intracoccygeal approach. The extent of pain relief was assessed by visual analog scale (VAS) at 24 hours, and at the first, third, and sixth weeks following the intervention. A questionnaire to evaluate subjective patient satisfaction was also used at each follow-up visit. Results In the CRF group, the mean VAS score decreased significantly from the baseline value at each follow-up visit. But in the PRF group, this decrease was insignificant except at 24-hour follow-up. Intergroup comparison also showed significantly better pain relief in the CRF group as compared with the PRF group. At the end of follow-up, 28 patients (82%) in the CRF group and four patients (13%) in the PRF group had excellent results, as assessed by the subjective patient satisfaction questionnaire. There was no complication in any patient of either study group, except for short-lived infection at the site of skin puncture in a few. Conclusion Ganglion Impar block by conventional radiofrequency provided a significantly better quality of pain relief with no major side effects in patients with chronic nononcological perineal pain as compared with pulsed radiofrequency. Limitations The short-term follow-up period of only six weeks was a major drawback associated with this study. [ABSTRACT FROM AUTHOR]

Purpose: We conducted a retrospective study to evaluate the efficacy and duration of pain relief for idiopathic trigeminal neuralgia (TN) patients after continuous radiofrequency (CRF) combined with pulsed radiofrequency (PRF) treatment of the Gasserian ganglion (GG). Methods: Twenty-one patients were treated with pulsed RF for 6 min repeated after rotating the needle tip by 180°, at a pulse width of 10 ms and at 45 °C. This was followed by conventional RF at 60 °C for 60 s, repeated after needle rotation by 180°, then finally at 65 °C for 60 s also repeated after needle rotation by 180°. Patients were assessed for pain intensity and consumption of analgesics at baseline and 7 days, 1 month, 6 months, and 12 months after the procedure. The patients' global impression of change (PGIC) scale was also assessed 7 days, 1 month, 6 months, and 12 months after the procedure. The incidence of facial dysthesia was evaluated 7 days after the procedure. Results: Excellent pain relief was achieved for 15 of 21 patients (71.4 %) after 1 week, 1 month, and 6 months. and for 14 of 21 patients (66.7 %) after 12 months. Consumption of analgesics was significantly reduced for more than 6 months, and for fifteen patients the PGIC scale result was very much improved 12 months after the procedure compared with baseline. Eighteen of the 21 patients (85.7 %) experienced facial dysthesia 1 week after the procedure. Conclusion: Excellent pain relief and reduced consumption of analgesics for more than 6 months were observed in patients who received PRF combined with CRF to the GG for treatment of idiopathic TN. [ABSTRACT FROM AUTHOR]

Summary: Background: The efficacy of PRF for lumbar facet joint pain is not well established because comparative studies with other modes of management are sparse. Aim: The purpose of this study was to compare the efficacy of conventional radiofrequency (CRF) and pulsed radiofrequency (PRF) denervation in the treatment of lumbar facet joint pain. Methods: Lumbar facet joint pain was confirmed in 40 patients undergoing double medial branch blocks. Among them, 16 patients received CRF for pain management and 18 patients were offered PRF. Outcome was assessed before treatment and 3 months and 6 months after treatment. Changes in pain intensity were evaluated using a visual analog scale (VAS). Physical functioning was evaluated using a Revised Oswestry Disability Index (ODI). Results: In the CRF group, the VAS scores after treatment were significantly lower than before treatment at 3 months (p <0.001) and 6 months (p =0.001). The revised ODI scores after treatment were lower at 3 months (p <0.001) and 6 months (p =0.001). In the PRF group, the VAS scores after treatment were also lower at 3 month (p <0.001) and 6 months (p <0.001). The revised ODI scores after treatment were lower at 3 months (p <0.001) and 6 months (p <0.001). The VAS scores in the CRF group were significant lower than scores in PRF group at 3 month (p =0.01) and 6 months (p =0.03). The differences in revised ODI scores between the two groups at 3 months and 6 months were not significant. Conclusions: Both PRF and CRF resolved low back pain from lumbar facet joints. However, CRF was more effective than PRF. [ABSTRACT FROM AUTHOR]

Background and Objective: In patients with knee pain due to gonarthrosis, we have treatments that are not free of side effects., Objective: to evaluate the analgesic efficacy of radiofrequency (pulsed and conventional) on the saphenous nerve at the subsartorial level and the genicular nerves of the knee, by ultrasonography., Materials and Methods: Prospective, randomized, double-blind clinical trial. G1 (RDF1): subjects subjected to radiofrequency, G2 (PLCB): subjects subjected to placebo. A decrease ≥30% of the pain was considered clinically relevant, according to numerical rating scale and in the Western Ontario and McMaster Universities Osteoarthritis Index, global patient impression questionnaire (PGIC) and health status questionnaire (SF-12) in the evaluation at month, three months and six months after the completion of the technique., Results: 28 patients (G1: 12, G2: 16), 72% women, age: 75.2±9.1 years, body mass index: 29.9±4.64. The analysis did not show a pain reduction, neither statistically significant, not clinically relevant, at one month, three, or six months with respect to the start of treatment, in the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and numerical rating scale (rest, movement). Regarding PGIC and the SF-12 questionnaire, there were no statistically significant differences between G1 and G2 either before or after treatment., Conclusions: The combination of two radiofrequency techniques, does not cause a reduction in the intensity of the knee pain, at month, three, or at six months after its completion. It is necessary to change the radiofrequency technique and include more variables to continue with the efficacy study., (Copyright © 2019 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)