Abstract No. : ABS2974: Comparative study between pulsed radiofrequency ablation and continuous radiofrequency ablation of splanchnic plexus for pain relief in patients with upper abdominal cancers - Adouble blinded randomised controlled study

Abstract

Background and Aims:The study compares the efficacy of pulsed radiofrequency ablation(RFA) versus continuous RFA in relieving pain ,improving quality of life and reducing daily morphine dosage amongst patients suffering from upper abdominal cancers.Methods:Fifty six patients presenting to the out patient department with intractable pain (visual analogue scale (VAS) score≥4) due to upper abdominal cancers despite taking oral morphine were randomly divided into two groups of 28 patients each. Patients in group 1 were given splanchnic plexus block using pulsed RFA at 42 degrees for 7 min and group 2 were given continuous RFA at 80 degrees for 90 seconds using C-arm and fluoroscopy-guided technique. The patients were followed up at 15 days, 1 month, 3 months and 6 months for the assessment of pain severity(VAS), quality of life(Edmonton Scale) and daily oral morphine dose.Results:Mean reduction in VAS Score was more for group 2 than group 1, at all follow ups and the difference was statistically significant at 1, 3 and 6 months. Mean Edmonton score and mean daily morphine dosage were significantly reduced in both groups at 15 days but the difference between 2 groups was statistically insignificant, and at subsequent follow ups these variables increased in both groups but the increase in group 1 was more than group 2 (figure 1).Figure 1- Comparison of the outcome parameters between the groups.Conclusion:Continuous RFA provides a better pain relief than pulsed RFA but there is no significant long term improvement in the quality of life and opioid consumption of patients with these interventions.