Qualitative assessment of chronic pain management in patients undergoing computed tomography-guided procedures

Ralph Jeffrey,Rupesh Mandava,Bhawna Dev,Praveenkumar Vasanthraj,Roy Santosham,Gayathri Nagenthran,Siddharth Saravanan

doi:10.1186/s43055-020-00390-0

Abstract

BackgroundTo study the qualitative efficacy and safety of percutaneous pain management under CT guidance. The success rate of medical management for chronic pain in long term is very less. This study aids in evaluating the clinical success rate in each CT-guided pain management procedure we have done.ResultsAmong the 60 patients, 39 (65%) were male patients and 21 (35%) were female patients. We did 40 celiac plexus neurolysis (66.7%), 13 radiofrequency ablations (21.6%), 4 stellate ganglion neurolysis (6.7%), and 3 trigeminal nerve neurolysis (5%). The average pre-procedural pain score in all the procedures was 7 which was significantly reduced to 1 in 24 h and 1 and 3 months.ConclusionPercutaneous pain management under CT guidance by virtue of its precise needle placement offers effective pain relief. It has a lower rate of complications, reduces the need for repeat procedures, and ultimately increases the quality of life.

Highlights

To study the qualitative efficacy and safety of percutaneous pain management under computed tomography (CT) guidance
The most common procedure in our study was celiac plexus neurolysis in 40 (66.7%), 13 cases underwent radiofrequency ablation (21.6%), 4 cases stellate ganglion neurolysis (6.7%), and 3 cases trigeminal nerve neurolysis (5%)
The maximum pre-procedural pain score in all the procedures was 9 in a patient with chronic pancreatitis which subsided to a pain score of 0 after 24 h post-celiac plexus neurolysis

Summary

Introduction

To study the qualitative efficacy and safety of percutaneous pain management under CT guidance. The success rate of medical management for chronic pain in long term is very less. Pain is defined as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage or described in terms of such damage.”. It affects the quality of the patient’s life by affecting their physical, psychological, and social aspects. Opioids are the mainstay of analgesics for chronically ill patients; they are not readily available in our country to common people; percutaneous pain management is preferred. C-arm fluoroscopy was used for facet and nerve root blocks using anatomical landmarks with a large amount of steroid and/or local anesthetics. Among the various imagingguided modalities like fluoroscopy, ultrasound (USG), Methods

Results

Discussion

Conclusion