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经皮脉冲射频关节突神经消融术治疗常规镇痛药物治疗无效的慢性髋关节疼痛。

Percutaneous pulsed radiofrequency ablation of articular nerves of the hip joint in patients with chronic hip pain refractory to conventional analgesics.

机构信息

Department of Anaesthesiology and Critical Care, Sancheti Hospital, Pune, India.

Department of Anesthesia, Pain Medicine and Critical Care, AIIMS, New Delhi, India.

出版信息

Agri. 2024 Apr;36(2):83-91. doi: 10.14744/agri.2023.90236.

DOI:10.14744/agri.2023.90236
PMID:38558402
Abstract

OBJECTIVES

Total Hip Arthroplasty (THA) may be a risky proposition in patients with comorbidities, and they may require systemic analgesics for chronic hip pain (CHP). Since traditional pain medications may not provide complete pain relief or carry prohibitive adverse effects, pulsed radiofrequency (PRF) treatment of the hip articular nerves (HAN) has been proposed for effective clinical outcomes. We determined the efficacy of PRF-HAN in improvement in CHP compared to baseline pain on conventional systemic analgesics.

METHODS

Between August 2015 and December 2021, 31 adult patients with severe comorbid conditions and excruciating chronic hip pain were subjected to a PRF-HAN procedure following a diagnostic block. All 31 patients received PRF of the articular branches of the femoral and obturator nerves. Demographic parameters, numerical rating scale (NRS), Harris Hip Score (HHS), WOMAC scores, the change of these scores from baseline, and any adverse effects were recorded before treatment and on day 1, 1st week, 6 weeks, and 6 months after treatment.

RESULTS

All the patients who underwent the PRF-HAN reported a significant improvement in NRS, HHS, and WOMAC scores compared to the baseline values on day 1, at the end of the 1st week, and the 6th week (p<0.001). No adverse events were documented in the study post-procedure until the end of 6 months.

CONCLUSION

PRF-HAN is a strong alternative for chronic pain management and augments physical functioning and a return to daily activity in patients who would be deprived of arthroplasty considering associated comorbid conditions.

摘要

目的

对于合并症患者,全髋关节置换术(THA)可能存在风险,他们可能需要全身性镇痛药来缓解慢性髋关节疼痛(CHP)。由于传统的止痛药物可能无法提供完全的止痛效果,或者会产生不可承受的不良反应,因此有人提出采用脉冲射频(PRF)治疗髋关节关节神经(HAN),以获得有效的临床效果。我们旨在确定与常规全身镇痛药物相比,PRF-HAN 治疗 CHP 的疗效。

方法

2015 年 8 月至 2021 年 12 月,31 例患有严重合并症和剧烈慢性髋关节疼痛的成年患者在诊断性阻滞后接受 PRF-HAN 治疗。所有 31 例患者均接受了股神经和闭孔神经关节支的 PRF 治疗。记录患者的人口统计学参数、数字评分量表(NRS)、髋关节评分(HHS)、WOMAC 评分,以及治疗前后基线时、治疗后第 1 天、第 1 周、第 6 周和第 6 个月的这些评分的变化,以及任何不良反应。

结果

所有接受 PRF-HAN 治疗的患者与基线相比,在第 1 天、第 1 周末和第 6 周时,NRS、HHS 和 WOMAC 评分均显著改善(p<0.001)。在研究期间直至 6 个月后,没有记录到任何术后不良事件。

结论

对于考虑到相关合并症而不能进行关节置换的患者,PRF-HAN 是一种有效的慢性疼痛管理替代方案,可增强身体功能并促进其恢复日常活动。

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