Ultrasound-guided Pulsed Radiofrequency in the Management of Thoracic Postherpetic Neuralgia
| Autor: | Hanaa M El Bendary, Salma E S Ahmed, Mahmoud Abdel Latif, Zainab M Sonbul, Mohamed Y. Makharita |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Pregabalin Neuralgia Postherpetic Intercostal nerves Thoracic Vertebrae law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial 030202 anesthesiology law medicine Humans Pain Management Ultrasonography Interventional Acetaminophen Analgesics Pulsed radiofrequency Postherpetic neuralgia business.industry Middle Aged medicine.disease Pulsed Radiofrequency Treatment Surgery Treatment Outcome Anesthesiology and Pain Medicine medicine.anatomical_structure Thoracic vertebrae Quality of Life Neuralgia Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies medicine.drug |
| Zdroj: | The Clinical Journal of Pain. 34:1017-1024 |
| ISSN: | 0749-8047 |
| DOI: | 10.1097/ajp.0000000000000629 |
| Popis: | This study was designed to evaluate the efficacy and safety of ultrasound-guided pulsed radiofrequency (PRF) for the intercostal nerves (ICNs) in the management of thoracic postherpetic neuralgia.After 2 weeks of treatment by pregabalin 150 mg/12 hours, patients were randomly allocated into 2 groups. The PRF group, after ultrasound-guided localization of the ICN of the affected thoracic dermatome, sensory stimulation of the ICN was tested. Thereafter, the patient received 2 cycles PRF at 42°C temperature, for 120 seconds. The sham group, after stimulation, the same time was spent to mimic PRF. The same procedures were repeated to the upper and lower adjacent ICNs. Pain intensity using Visual Analogue Scale (VAS), and total analgesics consumption were assessed at the baseline, every 2 weeks for 6 months then after 9 and 12 months. The duration of effective pain relief was recorded. Quality of life was evaluated using self-evaluation questionnaires (SF-36) at baseline then after 1, 3, 6, and 12 months.PRF group expressed a significant decrease on the VAS throughout the study period. VAS30 was reported in the PRF group until the 22nd week. Pregabalin and acetaminophen consumption was significantly lower in the PRF group. The 8 domains of the SF-36 revealed a significant improvement in the PRF group when compared with the sham group throughout the study period except for the physical role which displayed nonsignificant improvement.Ultrasound-guided PRF for ICNs in combination with pharmacotherapy seems to be a safe and effective treatment modality for postherpetic neuralgia. |
| Databáze: | OpenAIRE |
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