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脉冲射频与肩胛上神经阻滞治疗慢性肩部疼痛的对比随机研究。

Comparative Randomized Study Between Pulsed Radiofrequency and Suprascapular Nerve Block for the Treatment of Chronic Shoulder Pain.

机构信息

Department of Anesthesiology, Pain Intesive Care Federal University of Sao Paulo.

出版信息

Clin J Pain. 2024 Mar 1;40(3):182-186. doi: 10.1097/AJP.0000000000001184.

DOI:10.1097/AJP.0000000000001184
PMID:38050367
Abstract

OBJECTIVES

The primary objective of this study was to compare pain intensity after pulsed radiofrequency (RF) or suprascapular nerve block for the treatment of chronic shoulder pain. The secondary objectives were to compare the shoulder range of motion and supplementary analgesic requirement.

METHODS

This randomized and prospective study included 40 patients, with chronic shoulder pain allocated into 2 groups. One group underwent pulsed RF, and the other group was submitted to block (B) of the suprascapular nerve, guided by ultrasound. They were assessed for 12 weeks regarding pain intensity, the need for analgesia supplementation, and shoulder range of motion. Side effects were recorded.

RESULTS

Pain intensity on movement was lower in the RF group after 2, 4, and 8 weeks. At rest, pain intensity was lower in group RF than in group B after 12 weeks. Pain intensity was lower than before the procedure at all times evaluated, in both groups. There was no difference between groups in the range of motion. There was a need for tramadol supplementation in 1 patient in group RF and 2 in group B. Adverse effects observed were local pain (RF: 1), hematoma (RF: 1; B: 1), and lipothymia (B: 2).

DISCUSSION

Pulsed RF on the suprascapular nerve promoted an analgesic effect for 12 weeks. Regarding the intensity of pain on movement and at rest, there was a trend toward a better effect with RF than with nerve blockage treatment. In both groups, there was a reduction in pain intensity without serious adverse effects.

摘要

目的

本研究的主要目的是比较脉冲射频(RF)或肩胛上神经阻滞治疗慢性肩痛的疼痛强度。次要目的是比较肩部活动范围和补充镇痛需求。

方法

这项随机前瞻性研究纳入了 40 名慢性肩痛患者,分为两组。一组接受脉冲 RF 治疗,另一组接受超声引导下肩胛上神经阻滞(B)治疗。在 12 周内评估两组患者的疼痛强度、镇痛补充需求和肩部活动范围。记录不良反应。

结果

RF 组在治疗后 2、4 和 8 周时运动时的疼痛强度较低。在休息时,RF 组在 12 周时的疼痛强度低于 B 组。两组在所有评估时间点的疼痛强度均低于治疗前。两组在活动度方面无差异。RF 组有 1 例需要补充曲马多,B 组有 2 例。观察到的不良反应是局部疼痛(RF:1)、血肿(RF:1;B:1)和晕厥(B:2)。

讨论

肩胛上神经的脉冲 RF 治疗可产生长达 12 周的镇痛效果。就运动和休息时的疼痛强度而言,RF 治疗的效果趋势优于神经阻滞治疗。两组患者的疼痛强度均降低,且无严重不良反应。

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