脉冲射频治疗慢性术后睾丸痛：一项双盲、假对照、随机试验：三个月结果。

Pulsed Radiofrequency Treatment for Chronic Post-Surgical Orchialgia: A Double-Blind, Sham-Controlled, Randomized Trial: Three-Month Results.

机构信息

South Egypt Cancer Institute, Assuit University, Egypt.

Assuit University Hospital, Assuit University, Egypt.

出版信息

Pain Physician. 2018 Mar;21(2):199-205.

PMID:29565950

Abstract

BACKGROUND

Chronic post-surgical pain in the groin region represents a challenge for the managing physician and is a burden on the quality of life of the patient. None of the existing interventions or medical treatment is satisfactory.

OBJECTIVES

We aim to evaluate the analgesic efficacy of pulsed radiofrequency (PRF) applied to the ilioinguinal nerve and the genital branch of the genitofemoral nerve for patients suffering from chronic post-surgical orchialgia.

STUDY DESIGN

A prospective randomized, controlled clinical trial.

SETTING

An interventional pain unit in a tertiary center at a university hospital in Egypt.

METHODS

Seventy patients complaining of chronic post-surgical orchialgia were randomized into 2 groups: PRF group (n = 35), received pulsed radiofrequency on the ilioinguinal nerve and genital branch of the genitofemoral nerve, or sham group (n = 35). The percentage of patients that showed > 50 % reduction of their visual analog scale (VAS) pain score as well as the percentage of patients that did not require additional analgesic drugs was assessed. The VAS pain score and the global perceived effect (GPE) were reported during the 3-month follow-up period.

RESULTS

The percentage of patients that showed > 50% reduction of their VAS pain score was 80% (24/30) in the PRF group versus 23.33% (7/30) in the sham group. The percentage of patients that did not require analgesic drugs was 50% (15/30) in the PRF group versus 3.3% (1/30) in the sham group. There was a significant reduction of the mean post-procedural VAS pain score at 2, 4, 6, 8, and 12 weeks (P = 0.001) in the PRF group in comparison to the sham group. Likewise, there was a significant improvement of the GPE in the PRF group in comparison to the sham group (P = 0.00).

LIMITATIONS

The study's follow-up period was limited to 3 months only.

CONCLUSIONS

For patients suffering from chronic post-surgical orchialgia, PRF applied to the ilioinguinal nerve and the genital branch of the genitofemoral nerve is an effective treatment modality. It provides long-lasting pain relief and decreases the demand for pain medications.

KEY WORDS

Orchialgia, groin pain, radiofrequency, ilioinguinal nerve, genitofemoral nerve.

摘要

背景

腹股沟区慢性术后疼痛对治疗医生来说是一个挑战，也是患者生活质量的负担。现有的干预措施或治疗方法都不尽人意。

目的

我们旨在评估脉冲射频（PRF）应用于髂腹股沟神经和生殖股神经生殖支治疗慢性术后睾丸痛的镇痛效果。

研究设计

前瞻性随机对照临床试验。

设置

埃及一所大学附属医院的介入疼痛科。

方法

70 例慢性术后睾丸痛患者随机分为 2 组：PRF 组（n = 35），接受髂腹股沟神经和生殖股神经生殖支的脉冲射频治疗；假手术组（n = 35）。评估视觉模拟量表（VAS）疼痛评分>50%缓解的患者比例以及无需额外镇痛药物的患者比例。在 3 个月的随访期间报告 VAS 疼痛评分和总体感觉效果（GPE）。

结果

PRF 组 VAS 疼痛评分>50%缓解的患者比例为 80%（24/30），而假手术组为 23.33%（7/30）。PRF 组无需镇痛药物的患者比例为 50%（15/30），而假手术组为 3.3%（1/30）。PRF 组在术后 2、4、6、8 和 12 周时的平均 VAS 疼痛评分均显著降低（P = 0.001），与假手术组相比。同样，PRF 组的 GPE 也显著优于假手术组（P = 0.00）。