Department of Anaesthesiology and Intensive Therapy, Ludwik Bierkowski Independent Healthcare Centre of the Ministry of the Interior, Poznań, Poland.
Institute of Rural Health, Lublin Pain Practice, Lublin, Poland.
Anaesthesiol Intensive Ther. 2024;56(2):151-159. doi: 10.5114/ait.2024.139860.
Patients suffering from severe chronic pain often have problems finding an appropriate combination of painkillers. We retrospectively evaluated the effectiveness and safety of pulsed radiofrequency ablation (pRFA) of the genicular nerves in 96 patients with knee osteoarthritis (KO). We hypothesized that age, sex, and body mass index (BMI) may influence the quality of the pRFA treatment.
A diagnostic blockade with total volume of 9 ml of 1% lidocaine (WZF, Poland) combined with 4 mg of dexamethasone with subsequent pRFA with a radio frequency of 300-500 kHz under ultrasound guidance was used during the procedure. The study participants were assessed during regular monthly visits until 12 months.
The nerves' ultrasound identification was successful in 90.62% of the cases. According to the numeric rating scale (NRS), pain was reduced by 50% or more in 64.06% of the cases. The average pain relief period lasted just over 7 and a half months. There were no pRFA-related complications or side effects of the drugs used.
pRFA seems to be safe and effective for the treatment of chronic pain in KO. The outcome of the treatment may be related to the patient's age (block duration increased with patient age) and sex (in women, the therapeutic effect was more effectively prolonged) in our study group. There was also higher effectiveness of pRFA in high-BMI patients, which was close to statistical significance ( P = 0.053).
患有严重慢性疼痛的患者常常难以找到合适的止痛药组合。我们回顾性评估了膝关节骨性关节炎（OA）患者 96 例膝关节神经射频热凝术（pRFA）的有效性和安全性。我们假设年龄、性别和体重指数（BMI）可能会影响 pRFA 治疗的质量。
在超声引导下，使用 9 ml 1%利多卡因（WZF，波兰）加 4 mg 地塞米松的诊断性阻滞，随后进行 300-500 kHz 射频 pRFA。研究参与者在定期每月就诊期间进行评估，直至 12 个月。
90.62%的病例成功进行了神经超声识别。根据数字评分量表（NRS），64.06%的病例疼痛减轻 50%或以上。平均止痛期持续 7 个半月以上。没有与 pRFA 相关的并发症或药物相关的副作用。
pRFA 似乎是治疗膝关节 OA 慢性疼痛的一种安全有效的方法。在我们的研究组中，治疗效果可能与患者年龄（阻滞持续时间随患者年龄增加而增加）和性别（女性的治疗效果延长更有效）有关。pRFA 在高 BMI 患者中的有效性更高，接近统计学意义（P=0.053）。
