Pulsed Radiofrequency Application for the Treatment of Pain Secondary to Sacroiliac Joint Metastases

Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.

Hypoventilation and hypokalemia in a patient with poor oral intake in the postanesthesia care unit: A case report

We encountered a case of hypoventilation and hypokalemia in a patient with poor oral intake in the postanesthesia care unit (PACU). A 44-year-old woman underwent a total abdominal hysterectomy under general anesthesia. She was transferred to the PACU after 2 hr of surgery. After 11/2 hr, the patient exhibited hypoventilation, muscle weakness, and mental changes. She was reintubated and transported from the PACU to the intensive care unit. The arterial blood gas analysis results were as follows: pH, 7.27; PaCO2, 65 mmHg; PaO2, 68 mmHg; and serum potassium levels, 2.48 mmol/L. After 6 hr, she recovered with full consciousness.