Meltem UYAR, Tülin ARICI, Mustafa KURÇALOĞLU, Can EYİGÖR, Bora UZUNER, İdris Şevki KÖKEN

The effects of preadministration of local anesthetic on pulsed radiofrequency

Background/aim: Pulsed radiofrequency (PRF) has been reported to be a safe and reliable method for the management of a varietyof chronic pain syndromes. It is not known whether the preadministration of local anesthetic increases the size of the electrical field.We revealed the effects of administering local anesthetic on PRF and investigated whether they were related to local anesthetic or fluideffects.Materials and methods: Group 1 (n = 18) received PRF to the suprascapular nerve with 1 mL of bupivacaine, group 2 (n = 20) receivedPRF with 1 mL of physiological saline solution, and group 3 (n = 18) received PRF only.Results: There were significant improvements in visual analog scale (VAS) scores at 30 min, 1 month, and 3 months after treatment ingroup 1 (P < 0.05) and at 1 month and 3 months in groups 2 and 3 (P < 0.05). There was a significant improvement in VAS scores ingroup 1 compared with groups 2 and 3 at 30 min after treatment.Conclusion: PRF applied to the nerve along with local anesthetic may increase pain relief, especially in the early posttreatment period.The favorable effects may depend on the pharmacodynamic features of the local anesthetic.

PDF

___

Karataş GK, Meray J. Suprascapular nerve block for pain relief in adhesive capsulitis: comparison of two different techniques. Arch Phys Med Rehabil 2002; 83: 593-597.
Higuchi Y, Nashold BS Jr, Sluijter M, Cosman E, Pearlstein RD. Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons. Neurosurgery 2002; 50: 850-856.
Rohof OJ. Caudal epidural of pulsed radiofrequency in post herpetic neuralgia; report of three cases. Anesth Pain Med 2014; 25; 4: e16369.
Shah RV, Racz GB. Pulsed mode radiofrequency lesioning of the suprascapular nerve for the treatment of chronic shoulder pain. Pain Physician 2003; 6: 503-506.
Simopoulos TT, Nagda J, Aner MM. Percutaneous radiofrequency lesioning of the suprascapular nerve for the management of chronic shoulder pain: a case series. J Pain Res 2012; 5: 91-97.
Todorov L. Pulsed radiofrequency of the sural nerve for the treatment of chronic ankle pain. Pain Physician 2011; 14: 301- 304.
Liliang PC, Lu K, Liang CL, Tsai YD, Hsieh CH, Chen HJ. Pulsed radiofrequency lesioning of the suprascapular nerve for chronic shoulder pain: a preliminary report. Pain Med 2009; 70-75.
Eyigör C, Eyigör S, Korkmaz OK, Uyar M. Intraarticular corticosteroid injections versus pulsed radiofrequency in painful shoulder. Clin J Pain 2010; 26: 386-392.
Gofeld M, Restrepo-Garces CE, Theodore BR, Faclier G. Pulsed radiofrequency of suprascapular nerve for chronic shoulder pain: a randomized double-blind active placebo-controlled study. Pain Practise 2013; 13: 96-103.
Worster W, Lange CP, Briet RJ, Labuschagne BC, du Toit DF, Muller CJ, de Beer JF. The sensory branch distribution of the suprascapular nerve: an anatomic study. J Shoulder Elbow Surg 2008; 17: 500-502.
Luo F, Meng L, Wang T, Yu X, Shen Y, Ji N. Pulsed radiofrequency treatment for idiopathic trigeminal neuralgia: a retrospective analysis of the causes for ineffective pain relief. Eur J Pain 2013; 17: 1189-1192.
Chua NH, Halim W, Beems T, Vissers KC. Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth Pain Med 2012; 1: 257-261.
Tanaka N, Yamaga M, Tateyama S, Uno T, Tsuneyoshi I, Takasaki M. The effect of pulsed radiofrequency current on mechanical allodynia induced with resinifera toxin in rats. Anesth Analg 2010; 111: 784-790.
MacDermid JC, Solomon P, Prkachin K. The shoulder pain and disability index demonstrates factor, construct and longitudinal validity. BMC Musculoskelet Disord 2006; 7: 12.
Williams JW, Holleman DR, Simel DL. Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol 1995; 22: 727-732.
Cohen SP, Peterlin BL, Fulton L, Neely ET, Kurihara C, Gupta A, Mali J, Fu DC, Jacobs MB, Plunkett AR et al. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness. Pain 2015; 156: 2585-2594.
Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochir 2011; 153: 763-771.
Erdine S, Bilir A, Cosman ER, Cosman ER Jr. Ultrastructural changes in axons following exposure to pulsed radiofrequency fields. Pain Pract 2009; 9: 407-417.
Hagivara S, Iwasaka H, Takeshima N, Noquchi T. Mechanisms of analgesic action of pulsed radiofrequency on adjuvantinduced pain in the rat: roles of descending adrenergic and serotonergic systems. Eur J Pain 2009; 13: 249-252.
Hamann W, Abou-Sherif S, Thompson S, Hall S. Pulsed radiofrequency applied to dorsal root ganglia causes a selective increase in ATF3 in small neurons. Eur J Pain 2006; 10: 171- 176.
Igarashi A, Kikuchi S, Konno S. Correlation between inflammatory cytokines released from the lumbar facet joint tissue and symptoms in degenerative lumbar spinal disorders. J Orthop Sci 2007; 12: 154-160.
Sluijter ME, Teixeira A, Serra V, Balogh S, Schianchi P. Intraarticular application of pulsed radiofrequency for arthrogenic pain-report of six cases. Pain Pract 2008; 8: 57-61.
Bruners P, Müller H, Günther RW, Schmitz-Rode T, Mahnken AH. Fluid-modulated bipolar radiofrequency ablation: an exvivo evaluation study. Acta Radiol 2008; 49: 258-266.
Lee JM, Han JK, Kim SH, Shin KS, Lee JY, Park HS, Hur H, Choi BI. Comparison of wet radiofrequency ablation with dry radiofrequency ablation and radiofrequency ablation using hypertonic saline preinjection: ex-vivo bovine liver. Korean J Radiol 2004; 5: 258-265.
Provenzano DA, Lassila HC, Somers D. The effect of fluid injection on lesion size during radiofrequency treatment. Reg Anesth Pain Med 2010; 35: 338-342.
Provenzano DA, Lutton EM, Somers D. The effect of fluid injection on lesion size during bipolar radiofrequency treatment. Reg Anesth Pain Med 2012; 37: 267-276.
Provenzano DA, Liebert MA, Somers DL. Increasing the NACl concentration of the preinjected solution enhances monopolar radiofrequency lesion size. Reg Anesth Pain Med 2013; 38: 112-123.
Makharita MY, Amr YM. Pulsed radiofrequency for chronic inguinal neuralgia. Pain Physician 2015; 18: E147-E155.