Abstract
•Analyze the effectiveness and comparison of PRFA of Sphenopalatine ganglion and alcohol neurolysis for severe pain.•Pain Relief and Quality of life. Pain is present in up to 80% of patients with cancer of the head and neck. Pulsed radiofrequency ablation (PRFA) is relatively new use of an older procedure, conventional thermal radiofrequency. This study was designed to analyze the effectiveness and comparison of PRFA of Sphenopalatine ganglion and alcohol neurolysis for severe pain in the orofacial region in advanced head and neck cancer pain patients on oral morphine or fentanyl patch with or without adjuvant and to assess the Quality of life before and after radiofrequency ablation. 20 consecutive consenting patients of on oral morphine or fentanyl patch for cancer or cancer related pain in facial region were enrolled into the study and were divided into two equal groups of 10 patients each. One group received pulsed radiofrequency (Group P) after a positive diagnostic block and other group was given a diagnostic block followed by alcohol neurolysis (Group A). The pain intensity, percentage of pain relief, analgesic consumption, breakthrough pain, changes of any medication, side effects were recorded in each visits. Pain score (VRS) decreased in both the groups but statistically significantly in PRFA group (Group P) on 2nd day onward (1.4 vs 2.1 at 1week, 2.2 vs 2.6 at 1 month, 1.8 vs 2.8 at 3 month and 2.6 vs 3.1 at 6 month. All the patients experienced relief of pain and it was found to be statistically significant (P value<0.05). Analgesic consumption was decreased in both the groups. 2 patients in alcohol group reported burning as a side effect with 1 patient in RFA group reported increased pain for 2 days. The Karnofsky score improved from the baseline of 60 to 90 subsequently in both groups. Pulse Radio Frequency ablation and alcohol neurolysis of Sphenopalatine ganglion can be done for effective management of cancer facial pain.
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