EFFECTIVENESS OF ULTRASOUND GUIDED SUPRASCAPULAR NERVE BLOCK BY PULSED RADIOFREQUENCY ABLATION AND METHYLPREDNISOLONE INJECTION WITH LIGNOCAINE IN IMPROVING UPPER LIMB FUNCTION IN HEMIPLEGIC PATIENT WITH SHOULDER PAIN A RANDOMIZED CONTROLLED STUDY

Abstract

Objective:- To compare the effectiveness of ultrasound guided suprascapular nerve block by pulsed radiofrequency ablation and methylprednisolone injection with lignocaine in improving upper limb function in hemiplegic patient with shoulder pain Methods:- Sixty patients with hemiplegia with shoulder pain were included in a prospective, randomized controlled trial, which were distributed in two groups. The study group received ultrasound guided pulse radiofrequency ablation (PRFA) of suprascapular nerve, while the control group received single injection of 80mg methylprednisolone and 2 ml of 2% lignocaine. Outcome measures used were MAS (Motor assessment scale), VAS (visual analogue scale), SPADI (shoulder pain and disability index) and assessment were done at baseline, 1 week, 4 weeks and 12 weeks follow ups. Results:-All outcome measures in the study group and in the control group showed signicant improvement from the baseline (P< 0.05). Acomparison of the 2 groups indicated signicantly greater improvement in the study group at all times in MAS, VAS and SPADI scores (all P< 0.05). Conclusions:The present study found that ultrasound guided pulsed radiofrequency ablation and methylprednisolone block of suprascapular nerve rendered improvement in upper limb function and pain till 12 weeks. However, in terms of faster onset of disability reduction with greater pain relief, pulsed radiofrequency ablation of suprascapular nerve showed statistically signicant improvement in almost all outcome measures. Therefore, it is suggested that it might be the treatment of choice in future for improving upper limb function in patients with hemiplegia with shoulder pain.