Review article
SAFETY OF THE RADIOFREQUENCY DENERVATION FOR CHRONIC PAIN TREATMENT - SINGLE CENTRE EXPERIENCE FROM OSIJEK UNIVERSITY HOSPITAL CENTRE
IVANA HARŠANJI DRENJANČEVIĆ
orcid.org/0000-0003-0871-8562
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
IVAN RADOŠ
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
DARIJA VENŽERA-AZENIĆ
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
MARICA KRISTIĆ
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
OZANA KATARINA TOT
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
HRVOJE ČERNOHORSKI
; Osijek University Hospital Centre, Osijek, Croatia
IVAN OMRČEN
; Osijek University Hospital Centre, Osijek, Croatia
DINO BUDROVAC
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
GORDANA KRISTEK
; Osijek University Hospital Centre and Josip Juraj Strossmayer University in Osijek, School of Medicine Osijek, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia
Abstract
Treatment of patients suffering from chronic pain of any cause is very demanding and often involves multimodal approach. Analgesics, non-pharmacological methods (physical therapy and acupuncture), local anesthetics and corticosteroids as intraarticular injection or near the nerves are parts of this multimodal approach. Each part of this approach carries a certain risk of side effects and complications. Oral anti-infl ammatory drugs reduce pain and infl ammation, but in certain groups of patients they are contraindicated or represent a greater risk for side effects and complications. Opioid analgesics could be less tolerable for some patients during the treatment due to nausea or, in severe cases, vomiting and constipation, and patients often abandon these analgesics. Co-analgesics (antidepressants and anticonvulsants) are also medicines with signifi cant side effects, most of them are diffi cult to tolerate and patients are reluctant to take them. Non-pharmacological methods for treating chronic pain are mostly associated with minimal or no complications, but with limited analgesic effect. Intraarticular injections of local anesthetics and corticosteroids or injections in the epidural space also represent certain risks for complications. Radiofrequency denervation (neurotomy, ablation) is described in the literature as a minimal invasive procedure in order to induce thermal lesions on the nerves to stop the pain signals to the brain. Radiofrequency denervation is most commonly used in the following chronic pain conditions: trigeminal nerve neuralgia, cervical or back pain caused by degenerative infl ammatory changes in facet joints and osteoarthritis of hip and knee joints. During this procedure, as well
as during any other medical intervention, complications are possible, but rarely described in the literature. In this article, we provide an overview of the literature and our experiences associated with the complications of radiofrequency denervation of the nerves most commonly used.
Keywords
radiofrequency denervation; complications; trigeminal nerve neuralgia; facet joints; chronic knee pain
Hrčak ID:
224654
URI
Publication date:
14.7.2019.
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