Miñana José Miguel Esparza, Mazzinari Guido, Llopis-Calatayud Jose Emilio, Cerdá-Olmedo Germán
Escuela de Doctorado, Catholic University of Valencia San Vicente Mártir C/Guillem de Castro, 65, 46008 Valencia, Spain.
Department of Anaesthesiology and Pain Unit, Instituto Musculoesquelético Europeo (IMSKE), Valencia, Spain.
Indian J Anaesth. 2024 May;68(5):473-479. doi: 10.4103/ija.ija_1107_23. Epub 2024 Apr 12.
Painful shoulder is one of the most frequent consultation causes. Multiple treatments have been described to relieve pain, restore range of motion and improve functionality.
This randomised clinical trial was conducted in 60 patients. The treatment group received combined pulsed radiofrequency (PRF) on suprascapular nerve (SN) and axillary-circumflex nerve (ACN). The control group received PRF on SN only. The primary outcome was pain intensity measured by the Numerical Rating Scale (NRS). The secondary outcomes were the Shoulder Pain and Disability Index (SPADI), the Constant-Murley range of motion scale and Disability of the Arm, Shoulder and Hand (DASH) scale. The patients were monitored at the baseline visit and at 1, 3, 6 and 9 months. A mixed ordinal regression model was estimated to evaluate the association between the study group and pain measured with NRS.
A global decrease in pain at the end of the study was noted. The global baseline NRS was 8.4, and the global final NRS at 9 months of follow-up was 6.2. Combined PRF on SN and ACN was not associated with lower NRS pain scores compared to single SN PRF [odds ratio (OR) =1.04, 95% confidence interval (CI) 0.91-1.20, = 0.507]. Secondary outcomes showed no significant differences: SPADI (OR = 1.04, 95% CI 0.92-1.18), Constant-Murley (OR = 1.01, 95% CI 0.90-1.14), DASH (OR = 1.04, 95% CI 0.92-1.17).
Combined PRF applied to SN and ACN was not superior to PRF applied to SN alone.
肩部疼痛是最常见的就诊原因之一。已有多种治疗方法用于缓解疼痛、恢复活动范围并改善功能。
本随机临床试验纳入了60例患者。治疗组接受肩胛上神经（SN）和腋神经（ACN）联合脉冲射频（PRF）治疗。对照组仅接受SN的PRF治疗。主要结局指标为采用数字评分量表（NRS）测量的疼痛强度。次要结局指标包括肩痛和功能障碍指数（SPADI）、Constant-Murley活动范围量表以及手臂、肩部和手部功能障碍（DASH）量表。在基线访视时以及第1、3、6和9个月对患者进行监测。采用混合有序回归模型评估研究组与用NRS测量的疼痛之间的关联。
研究结束时疼痛总体减轻。基线时NRS总体评分为8.4，随访9个月时最终NRS总体评分为6.2。与单独的SN的PRF相比，SN和ACN联合PRF与更低的NRS疼痛评分无关[优势比（OR）=1.04，95%置信区间（CI）0.91 - 1.20，P = 0.507]。次要结局指标无显著差异：SPADI（OR = 1.04，95% CI 0.92 - 1.18）、Constant-Murley（OR = 1.01，95% CI 0.90 - 1.14）、DASH（OR = 1.04，95% CI 0.92 - 1.17）。
应用于SN和ACN的联合PRF并不优于单独应用于SN的PRF。
