Conventional Radiofrequency Ablation More Effective Than Pulsed Radiofrequency for Perineal Pain

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Pain relief and patient satisfaction were evaluated with the Visual Analog Scale and a questionnaire, respectively.
Pain relief and patient satisfaction were evaluated with the Visual Analog Scale and a questionnaire, respectively.

In patients with chronic non-oncological perineal pain, ganglion impar block with conventional radiofrequency (RF) may result in improved pain relief compared with pulsed RF ablation, according to a recent study published in Pain Medicine.

In this prospective study, patients with chronic non-oncological perineal pain in India were randomly assigned to receive fluoroscopy-guided ganglion impar block with conventional RF ablation (n=34) or pulsed RF ablation (n=31). Pain relief and patient satisfaction were evaluated with the Visual Analog Scale and a questionnaire, respectively, 1 day and 1, 3, and 6 weeks after intervention.

Patients who received conventional RF ablation reported reduced mean pain scores from baseline at all follow-up visits: 1 day (P =.0093), 1 week (P =.0318), 3 weeks (P =.0001), and 6 weeks (P =.0001). In contrast, the patients who received pulsed RF had improved pain 1 day post-intervention (P =.0402), but not at the other follow-up visits.

The improvement in pain scores from baseline were significantly better in the conventional RF group than in the pulsed RF group at 1 week (P =.0004), 3 weeks (P =.0222), and 6 weeks (P =.0001) post-intervention. A greater percentage of patients in the conventional RF group rated their patient satisfaction as excellent or good at 1 week (P =.021), 3 weeks (P =.001), and 6 weeks (P =.002) post-intervention.

Infection at the site of skin puncture was reported in 3 of 34 patients in the conventional RF group and in 2 of 31 patients in the pulsed RF group. No other adverse events were reported.

The study investigators concluded that "ganglion impar block by conventional radiofrequency provides significantly better pain relief as compared with pulsed radiofrequency, with no major side effects in patients with chronic nononcological perineal pain."

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Reference

Usmani H, Dureja GP, Andleeb R, Tauheed N, Asif N. Conventional radiofrequency thermocoagulation vs pulsed radiofrequency neuromodulation of ganglion impar in chronic perineal pain of nononcological origin [published online January 10, 2018]. Pain Med. doi:10.1093/pm/pnx244

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