Faculty Collaboration Database

Pulsed radiofrequency of the dorsal root ganglia is superior to pharmacotherapy or pulsed radiofrequency of the intercostal nerves in the treatment of chronic postsurgical thoracic pain. Pain Physician 2006 Jul;9(3):227-35

Date

08/04/2006

Pubmed ID

16886031

Scopus ID

2-s2.0-33747169881 (requires institutional sign-in at Scopus site)   124 Citations

Abstract

BACKGROUND: Chronic postsurgical thoracic pain (CPTP) represents a major therapeutic challenge characterized by an absence of clinical studies to guide treatment. Recently, the implementation of pulsed radiofrequency (RF) has generated intense interest in the medical community as a safe and potentially effective treatment for neuropathic pain. To date, there are no studies comparing pulsed RF to more conventional therapeutic modalities for any pain condition.

OBJECTIVES: To compare treatment outcomes between pharmacotherapy, pulsed RF of the intercostal nerves (ICN) and pulsed RF of the dorsal root ganglia (DRG) in CPTP.

METHODS: Retrospective data analysis involving 49 patients.

RESULTS: At 6-week follow-up, 61.5% of the pulsed RF DRG group reported > or =50% pain relief vs. 27.3% in the medical management (MM) group and 21.4% in the IC group (P = 0.12). At 3-month follow-up, 53.8% in the DRG group continued to report > or = 50% pain relief vs. 19.9% in the MM and 6.7% in the ICN groups, respectively (P = 0.02). Among the pulsed RF patients who did report a successful outcome, the mean duration of pain relief was 2.87 months in the ICN group and 4.74 months in the DRG group (P = 0.01).

CONCLUSIONS: Pulsed RF of the DRG was a superior treatment to pharmacotherapy and pulsed RF of the ICN in patients with CPTP. Prospective studies are needed to confirm these results and identify the best candidates for this treatment.

Author List

Cohen SP, Sireci A, Wu CL, Larkin TM, Williams KA, Hurley RW

Author

Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Amines
Analgesics
Anticonvulsants
Carbamazepine
Catheter Ablation
Chronic Disease
Cyclohexanecarboxylic Acids
Female
Fluoroscopy
Ganglia, Spinal
Humans
Male
Mastectomy
Middle Aged
Nortriptyline
Pain, Postoperative
Retrospective Studies
Thoracotomy
Treatment Outcome
gamma-Aminobutyric Acid