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Pain and Therapy

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Open Access 01-06-2021 | Headache and Facial Pain | Review

Interventional Radiofrequency Treatment for the Sympathetic Nervous System: A Review Article

Authors: Nicholas A. Zacharias, Jay Karri, Carol Garcia, Laura K. Lachman, Alaa Abd-Elsayed

Published in: Pain and Therapy | Issue 1/2021

Abstract

Introduction

Interventional techniques such as radiofrequency (RF) treatment can be used to interrupt pain signals transmitted through the sympathetic nervous system (SNS). RF treatments including the pulsed (PRF) and continuous (CRF) modalities show enhanced control over lesion size and enhanced ability to confirm accurate positioning compared to other interventional methods. PRF also acts to reduce the area of the lesion. In this article, we characterize the currently available evidence supporting the use and efficacy of RF treatments in sympathetically mediated pain (SMP) conditions.

Study Design

A comprehensive literature review.

Methods

A PubMed and Cochrane Library database search was performed for human studies applying RF treatment at sympathetic sites (sphenopalatine ganglion, stellate ganglion, cervical, thoracic, or lumbar sympathetic ganglia, celiac plexus, splanchnic nerves, superior hypogastric plexus, and ganglion impar) between January 1970 to May 2020. Data were extracted, summarized into tables, and qualitatively analyzed.

Results

PRF and CRF both show promise in relieving SMP conditions, such as complex regional pain syndrome (CRPS), pain in the perineal region, headache and facial pain, and oncologic and non-oncologic abdominal pain, in addition to other types of pain, with minimal complications. Furthermore, in most comparative studies, outcomes using RF treatments exceeded other interventional techniques, such as anesthetic block and chemical neurolysis.

Conclusions

RF treatments can be effective in carefully selected patients who are refractory to conservative management. However, further randomized controlled studies are needed prior to implementing it into common practice.

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Title: Interventional Radiofrequency Treatment for the Sympathetic Nervous System: A Review Article
Authors: Nicholas A. Zacharias
Jay Karri
Carol Garcia
Laura K. Lachman
Alaa Abd-Elsayed
Publication date: 01-06-2021
Publisher: Springer Healthcare
Keywords: Headache and Facial Pain
Sympathectomy
Complex Regional Pain Syndrome
Cluster Headache
Complex Regional Pain Syndrome
Published in: Pain and Therapy / Issue 1/2021
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI: https://doi.org/10.1007/s40122-020-00227-8

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