Efficacy and safety of pulsed radiofrequency and steroid injection for intercostobrachial neuralgia in postmastectomy pain syndrome - A clinical trial.

BACKGROUND: Breast cancer is a common neoplastic tumor in women, and the postmastectomy pain syndrome has been reported frequently after surgical treatment. The injury of the intercostobrachial nerve is considered the major cause of this type of pain. PURPOSE: Evaluation of efficacy and safety of pulsed radiofrequency (PRF) and steroid injection on the 2nd and 3rd thoracic (T2 and T3) dorsal root ganglions (DRGs) for intercostobrachial neuralgia (ICBN) postmastectomy. PATIENTS AND METHODS: This study was conducted on 100 patients with ICBN postmastectomy. The PRF waves were applied for 120 s twice on T2 and T3 DRGs then 1 ml of 4 mg dexamethasone and 1 ml of bupivacaine 0.25% were injected at each level then the technique was repeated three times 1 week apart for each patient. RESULTS: After 6 months from the latest intervention, the mean of visual analog scale dropped from 7.48 to 4.7 (P = 0.005712) and the mean of the quality of life scale improved to 6.88 after being 4.66 (P < 0.00001) before the intervention and 64.68% of the patients decided that they would certainly repeat the procedure if they could go back in time and 66.64% would certainly recommend the same procedure to a family member. The analgesics consumption decreased mainly in the 1st month but increased again after 6 months (not significant). No serious complications were recorded. CONCLUSIONS: PRF and steroid injection on T2 and T3 DRGs assumed an effective and safe method for ICBN postmastectomy treatment.

A new catheter technique for thoracic subarachnoid neurolysis in advanced lung cancer patients.

Subarachnoid neurolytic block (dorsal rhizotomy) was carried out in patients suffering from severe pain unresponsive to analgesic therapy. An intrathecal catheter technique was performed in 20 patients with lung cancer. Visual analog scale (VAS) for pain, patient satisfaction, and complications were recorded at 24 hours, 1 week, and 1, 2, and 3 months after procedure. VAS and patient satisfaction significantly decreased at measured time points (P < 0.05). Duration of procedure was 20.3 +/- 6.4 minutes; no significant complications were reported. This new intrathecal catheter technique for dorsal rhizotomy in advanced lung cancer patients was an easily performed, effective, and safe technique in this setting.