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Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy

BACKGROUND: Painful diabetic peripheral neuropathy (PDPN) is one of the most common complications of diabetes. PDPN seriously affects the quality of life and is difficult to treat; therefore, there is an urgent need for new cost-effective treatment methods for PDPN. OBJECTIVE: To investigate the eff...

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Autores principales: Ding, Yuanyuan, Yao, Peng, Li, Hongxi, Zhao, Rongjie, Zhao, Guangyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067610/
https://www.ncbi.nlm.nih.gov/pubmed/30100752
http://dx.doi.org/10.2147/JPR.S175514
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author Ding, Yuanyuan
Yao, Peng
Li, Hongxi
Zhao, Rongjie
Zhao, Guangyi
author_facet Ding, Yuanyuan
Yao, Peng
Li, Hongxi
Zhao, Rongjie
Zhao, Guangyi
author_sort Ding, Yuanyuan
collection PubMed
description BACKGROUND: Painful diabetic peripheral neuropathy (PDPN) is one of the most common complications of diabetes. PDPN seriously affects the quality of life and is difficult to treat; therefore, there is an urgent need for new cost-effective treatment methods for PDPN. OBJECTIVE: To investigate the efficacy and safety of radiofrequency thermocoagulation (RF) combined with anhydrous ethanol (AE) chemical blockade of lumbar sympathetic ganglia (LSG) in patients with PDPN using computed tomography (CT). STUDY DESIGN: Retrospective comparative study. SETTING: Shengjing Hospital of China Medical University. METHODS: Ninety patients diagnosed with PDPN were enrolled in this study. The patients were randomly divided into AE group (A, n=30), RF group (B, n=30), and RF+ AE group (C, n=30). The follow-up included preoperative basic conditions, visual analog scale (VAS), the total remission rate (TRR), skin temperature (ST) and the improvement of numbness and hyperalgesia in the lower extremities, complications, and degree of satisfaction (DOS) before and after surgery. RESULTS: Postoperative VASs were significantly decreased compared to preoperative VASs in all groups (P<0.05). The VAS in group A began to increase 3 months (3M) after surgery; VAS scores at 3M, 6 months (6M) and 1 year (1Y) were significantly different compared to group B and C (P<0.05); VAS in group B began to increase after 6M; VAS scores at 6M and 1Y were significantly different compared to group C (P<0.05); Moreover, group C maintained relatively long duration of pain relief. TRR in group A, group B and group C at 1Y after operation was 66.7%, 73.3% and 93.3%, respectively; TRR in group C was statistically different compared to groups A and B (P<0.05). Higher ST in the lower extremities was observed after surgery in all groups compared to peroration (P<0.05); nonetheless, the difference was not statistically significant. The numbness and hyperalgesia improved in all three groups after surgery compared to preoperational time, the numbness in group C was significantly higher compared to groups A and B. In addition, no severe complications were observed. At 6M and 1Y after surgery, the degree of satisfaction in patients from group C was significantly higher compared to groups A and B. CONCLUSION: Radiofrequency thermocoagulation combined with AE chemical blockade of the LSG was safe and effective. Nevertheless, the details underlying analgesic mechanisms still need to be investigated.
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spelling pubmed-60676102018-08-10 Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy Ding, Yuanyuan Yao, Peng Li, Hongxi Zhao, Rongjie Zhao, Guangyi J Pain Res Original Research BACKGROUND: Painful diabetic peripheral neuropathy (PDPN) is one of the most common complications of diabetes. PDPN seriously affects the quality of life and is difficult to treat; therefore, there is an urgent need for new cost-effective treatment methods for PDPN. OBJECTIVE: To investigate the efficacy and safety of radiofrequency thermocoagulation (RF) combined with anhydrous ethanol (AE) chemical blockade of lumbar sympathetic ganglia (LSG) in patients with PDPN using computed tomography (CT). STUDY DESIGN: Retrospective comparative study. SETTING: Shengjing Hospital of China Medical University. METHODS: Ninety patients diagnosed with PDPN were enrolled in this study. The patients were randomly divided into AE group (A, n=30), RF group (B, n=30), and RF+ AE group (C, n=30). The follow-up included preoperative basic conditions, visual analog scale (VAS), the total remission rate (TRR), skin temperature (ST) and the improvement of numbness and hyperalgesia in the lower extremities, complications, and degree of satisfaction (DOS) before and after surgery. RESULTS: Postoperative VASs were significantly decreased compared to preoperative VASs in all groups (P<0.05). The VAS in group A began to increase 3 months (3M) after surgery; VAS scores at 3M, 6 months (6M) and 1 year (1Y) were significantly different compared to group B and C (P<0.05); VAS in group B began to increase after 6M; VAS scores at 6M and 1Y were significantly different compared to group C (P<0.05); Moreover, group C maintained relatively long duration of pain relief. TRR in group A, group B and group C at 1Y after operation was 66.7%, 73.3% and 93.3%, respectively; TRR in group C was statistically different compared to groups A and B (P<0.05). Higher ST in the lower extremities was observed after surgery in all groups compared to peroration (P<0.05); nonetheless, the difference was not statistically significant. The numbness and hyperalgesia improved in all three groups after surgery compared to preoperational time, the numbness in group C was significantly higher compared to groups A and B. In addition, no severe complications were observed. At 6M and 1Y after surgery, the degree of satisfaction in patients from group C was significantly higher compared to groups A and B. CONCLUSION: Radiofrequency thermocoagulation combined with AE chemical blockade of the LSG was safe and effective. Nevertheless, the details underlying analgesic mechanisms still need to be investigated. Dove Medical Press 2018-07-26 /pmc/articles/PMC6067610/ /pubmed/30100752 http://dx.doi.org/10.2147/JPR.S175514 Text en © 2018 Ding et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Ding, Yuanyuan
Yao, Peng
Li, Hongxi
Zhao, Rongjie
Zhao, Guangyi
Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title_full Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title_fullStr Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title_full_unstemmed Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title_short Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
title_sort evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067610/
https://www.ncbi.nlm.nih.gov/pubmed/30100752
http://dx.doi.org/10.2147/JPR.S175514
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