Radiofrequency Treatment Research Articles

Factors influencing the cost-effectiveness of radiofrequency ablation for Barrett's esophagus with low-grade dysplasia in Australia.

Endoscopic eradication therapy using radiofrequency ablation (RFA) is considered an acceptable alternative to surveillance monitoring for Barrett's esophagus with low-grade dysplasia (LGD). This study aimed to estimate whether RFA for LGD is cost-effective and to determine which factors influence cost-effectiveness. A Markov model was developed to estimate the incremental cost per quality-adjusted life year (QALY) gained for RFA compared with endoscopic surveillance. An Australian longitudinal cohort study (PROBE-NET) provides the basis of the model. Replacing surveillance with RFA yields 10 fewer cases of HGD and 9 fewer esophageal adenocarcinoma (EAC)-related deaths per 1000 patients' treatment, given on average 0.192 QALYs at an additional cost of AU$9211 (€5689; US$6262) per patient (incremental cost-effectiveness ratio AU$47,815 per QALY). The model is sensitive to the rate of EAC from LGD health state, the utility values, and the number of RFA sessions. Hence, the incremental benefit ranges from 0.080 QALYs to 0.198 QALYs leading to uncertainty in the cost-effectiveness estimates. When the cancerous progression rate of LGD falls <0.47% per annum, the cost-effectiveness of RFA becomes questionable. RFA treatment of LGD provides significantly better clinical outcomes than surveillance. The additional cost of RFA is acceptable if the LGD to EAC rate is >0.47% per annum and no more than three RFA treatment sessions are provided. Accurate estimates of the risk of developing EAC in patients with LGD are needed to validate the analyses.

Radiofrequency treatments for lumbar facet joint syndrome: a systematic review and network meta-analysis.

Lumbar facet joint syndrome (FJS) is a common cause of chronic low back pain (LBP). Radiofrequency treatments are commonly used to treat chronic LBP-related FJS that is refractory to conservative treatment, although evidence supporting this treatment is controversial. We explored the therapeutic effects of radiofrequency on FJS using a network meta-analysis (NMA). A comprehensive systematic search of multiple databases was conducted to identify randomized controlled trials (RCTs) that compared radiofrequency with other treatments (sham procedures, facet joint corticosteroid injection, and conservative treatment) for FJS. We searched PubMed, Embase, Web of Science, the Cochrane Database, and handsearching. The primary outcomes were pain score and Oswestry Disability Index (ODI). Statistical analysis included conventional pairwise meta-analysis and NMA using the frequentist method. The treatments were ranked using surface under the cumulative ranking curve (SUCRA) values. The search yielded 25 RCTs (1969 patients) and a mixed quality regarding the risk of bias, with most studies exhibiting a low risk of bias for most domains. Endoscopic neurotomy consistently ranked highest in terms of pain reduction and ODI score improvement at 1, 3, 6, and 12 months. At 1 and 6 months, endoscopic neurotomy had the highest SUCRA value for pain reduction (0.833 and 0.860, respectively), followed by medial branch thermal radiofrequency. This NMA demonstrates that endoscopic neurotomy is the most effective treatment for lumbar FJS, providing superior and sustained pain relief and functional improvement compared with other treatments. Further, high-quality RCTs are needed to confirm these findings and address the existing limitations. CRD42024524657.

Current Management of Pediatric Patients with Post-Burn Scars: Case Study

Background. Post-burn scars are common among pediatric patients. Pathological scarring is clear indication for conservative or surgical management of pediatric patients who continue to grow and develop after the resolution of burn injuries. Such lesions can significantly reduce patients' quality of life and, moreover, cause significant functional and aesthetic discomfort. Clinical cases description. The results of observation over two children (2 years 7 months and 12 years) with developing post-burn scars are demonstrated. Successful management method using physiotherapeutic complex (including monopolar radiofrequency treatment combined with ultrasound therapy, photodynamic therapy, and close-focus X-ray therapy) is presented. Conclusion. Modern trends in post-burn scars management are based on timely implementation of effective and safe methods early on rehabilitation stages and tissue restoration after burn injury to prevent pathological scarring and achieve control over its activity.

Radio frequency inactivation of Bacillus cereus and natural microbiota in brown rice: Evaluation of inactivation kinetics and germination capacity

Brown rice and its sprout are prone to be contaminated by foodborne pathogens, resulting in potential safety issues. Effective pasteurization methods rely on the thermal death kinetics of the targeted microorganisms and gemination rate of brown rice. This study investigated the influence of five temperature and four moisture content (MC) levels on inactivation kinetics of Bacillus cereus or native microbiota and germination capacity changes of brown rice by radio frequency (RF) heating using first-order, Weibull and Biphasic models. Results showed that increasing MC and treatment temperature greatly enhanced the inactivation of B. cereus but excessive temperature (>75 °C) impaired seed physiology and reduced germination capacity of brown rice. The selected RF treatment (85 °C for 20 min and 80 °C for 30 min for samples with 14.2 % w.b., 75 °C for 30 min, 80 °C for 20 min, and 85 °C for 5 min for samples with 16.2 % w.b.) could reduce the populations of B. cereus by approximately 4.0 log CFU/g, whereas the reductions in total bacteria, yeasts and molds were less than 3.0 log CFU/g. Compared with the first-order linear model and Biphasic model, Weibull model provided the better fitted inactivation kinetics with superior statistical values (R2: 0.944–0.999; RMSE: 0.002–0.879) and validation indices (accuracy factor: 1.003–1.034; bias factor: 0.991–1.025) at all MCs and temperatures. The established Weibull model may offer a reliable method for fitting the inactivation kinetics of B. cereus in brown rice and would help the grain industry to develop effective RF pasteurization protocols.

Effect of radiofrequency ablation on improving cardiac structure and function in patients with atrial fibrillation and functional mitral regurgitation

Objective: Exploring the effect of radiofrequency ablation treatment to restore sinus rhythm on the improvement of functional mitral regurgitation (FMR) and cardiac structure in patients with atrial fibrillation combined with moderate or severe FMR, compared with drug therapy alone. Methods: This retrospective cohort study consecutively enrolled patients diagnosed with persistent atrial fibrillation and moderate or severe FMR who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2021. Forty-eight patients who were treated with radiofrequency ablation and maintained sinus rhythm were enrolled in the ablation group, and 63 patients who were treated with medication alone during the same period were in the medicine group. Patients in the ablation group and medicine group were matched in a 1∶1 ratio using a propensity score, and 41 patients were finally included in each of the 2 groups. All patients reexamined echocardiography after 3-month of treatment. The proportion of patients with FMR improvement and the differences in changes of cardiac structural and functional parameters were compared between groups. Results: After propensity score matching, the ablation group was aged (69.3±7.1) years with 21 males (51.2%) and the medicine group was aged (71.3±9.4) years with 21 males (51.2%). The echocardiography after 3-month of treatment showed the rate of FMR improvement was significantly higher in the ablation group than in the medicine group (19 (46.3%) vs. 33 (80.5%), P<0.001), and patients in the ablation group showed a significant decrease in FMR extent (Δmitral regurgitation area: (-1.30±2.64) cm2 vs. (-3.55±2.50) cm2, P<0.001), left atrial size (Δleft atrial diameter: (-0.17±3.78) mm vs. (-2.46±4.01) mm, P=0.009) and E/e' (ΔE/e':-2.54±7.34 vs.-6.34±7.08, P=0.021) compared with the medicine group. There was also a significant decrease in left ventricular size (Δleft ventricular end diastolic diameter: (-3.12±6.62) mm vs. (-0.73±3.62) mm, P=0.046) and significant increase in left ventricular ejection fraction (Δleft ventricular ejection fraction: (2.73±9.69) % vs. (-0.93±5.41) %, P=0.038) in ablation group. Conclusion: Performing radiofrequency ablation to restore sinus rhythm can effectively reduce the severity of mitral regurgitation and improve left atrial and left ventricular remodeling and cardiac function in patients with atrial fibrillation and FMR.

Temperature-controlled radiofrequency treatment of the nasal valve in nasal airway obstruction patients with septal deviation.

Nasal valve treatment with TCRF results in NAO symptom improvement in the presence of septal deviation. Severe septal deviation does not impact the beneficial effect of TCRF nasal valve treatment. Symptoms improve with TCRF nasal valve treatment even if septal deviations involve the nasal valve.

The Therapeutic Effect of Monopolar Radiofrequency Therapy on Urinary Symptoms and Sexual Function.

Objectives: Stress urinary incontinence (SUI) negatively affects the quality of life and sexual function in women. This study aimed to evaluate the efficacy of radiofrequency (RF) therapy in reducing SUI symptoms and its impact on sexual function. Methods: Thirty-four women with SUI were enrolled and underwent a single RF treatment session using the Viveve® System (Viveve Medical Inc., USA) with parameters of 90 J/cm2 and 220 pulses per hour. Assessments at baseline and 6 months post treatment included perineal ultrasound and personal interviews to evaluate lower urinary tract symptoms and sexual function. Urodynamic studies, voiding diaries, and questionnaires such as the Female Sexual Function Index (FSFI), Overactive Bladder Symptom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) measured outcomes. Results: RF therapy significantly improved sexual function, with higher FSFI scores in all domains except pain at 6 months. SUI symptoms were significantly reduced, as indicated by improved scores on OABSS, UDI-6, IIQ-7, and ICIQ-SF, alongside better voiding diary results. Anatomical changes included reduced bladder neck mobility, decreased vaginal width, and a reduced rotation angle of the proximal urethra. Conclusions: RF therapy is effective and safe for treating mild to moderate SUI and enhances sexual function, potentially due to changes in vaginal topography. These results suggest RF therapy as a viable non-surgical option for managing SUI and improving sexual health.

Approach to Validate ISPM-15 Compliance for Commercial Treatment Certification of Dielectric Standard Heating of Bulk Solid Wood Packing Materials using Radio Frequency

Abstract To substantially reduce the risk of alien invasive species moving to new geographic areas, phytosanitary treatment of wood packaging materials (WPM) in compliance with the International Standard of Phytosanitary Measures No. 15 (ISPM-15) is required by trading partners. Approved treatments include conventional heating, methyl bromide and sulfuryl fluoride fumigation, and dielectric heating (DH). The DH standard was officially adopted in 2013 but has not been practiced commercially due primarily to insufficient operational validation at commercial scale. In 2022, we converted our 50-kW radio frequency (RF) unit with a 1,200-board foot capacity from an oscillator electromagnetic field power generator to a solid-state power supply, which allows for selective power input adjustments during treatment; we also switched from a five-plate to a three-plate winged electrode system to improve heating uniformity. Each loading cycle can treat sufficient material to build ∼94 standard Grocery Manufacturers Association pallets. Our research team characterized the dielectric heating pattern and options for monitoring wood temperatures over a wide-ranging test matrix of WPM that varied by wood species, dimension, moisture content, and loading configuration. We found that this upgraded RF system markedly reduced treatment times and improved heating uniformity, allowing us to develop methods that can be used to verify compliance with ISPM-15 for improved technology transfer to industry. We also discuss the operational cost of RF treatment and make general cost comparisons to conventional heat treatment for WPM.

Twelve-month outcomes following temperature-controlled radiofrequency treatment of the septal swell body for nasal airway obstruction.

Improved nasal airway obstruction (NAO) symptoms were reported at 3 months following temperature-controlled radiofrequency (TCRF) treatment of the septal swell body (SSB). This report provides results from assessments of the long-term safety and efficacy of TCRF treatment of SSB hypertrophy to treat NAO through 12 months posttreatment. This prospective, multicenter, long-term, open-label study was conducted in nine centers within the United States and included patients with severe/extreme NAO attributed to SSB hypertrophy. Outcome measures included assessments of Nasal Obstruction Symptom Evaluation Score (NOSE), Numeric Rating Scale (NRS) ease-of-breathing, patient satisfaction, and adverse events at 6 and 12 months. Of the 70 patients treated, 65 and 62 patients completed the 6- and 12-month follow-up assessments. Compared to baseline, there was a 67.5% decrease in adjusted mean NOSE scores at 6 months (mean change -49.6, 95% confidence interval [CI] -54.8 to -44.4; p<0.001) and a 65.4% decrease at 12 months (mean change -48.1, 95% CI -53.7 to -42.5); p<0.001), which is consistent with previously published 3-month results. A 62.0% and 62.5% improvement compared to baseline was observed in the NRS ease-of-breathing score at 6 and 12 months, respectively (p<0.001). No serious adverse were reported overall and no new device- or procedure-related adverse events were reported in the interval between 3 and 12 months posttreatment. TCRF treatment of SSB hypertrophy has a significant and durable effect on improving the symptoms of NAO and health-related quality of life in patients with symptoms of nasal obstruction and congestion through 12 months postprocedure.

ID: 334966 Pulsed Radiofrequency Treatment for Chronic Pain: Real-World Outcomes In Europe

ID: 334966 Pulsed Radiofrequency Treatment for Chronic Pain: Real-World Outcomes In Europe

A Novel Transverse Ultrasound-Guided Approach for Puncturing the Cervical Dorsal Root Ganglion at the Level of Articular Pillar for Radiofrequency Treatment.

Currently, minimally invasive intervention surgery for cervical spondylotic radiculopathy mostly involves the use of cervical dorsal root ganglion (DRG) block or radiofrequency modulation therapy. Here, we proposed a novel transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment. A retrospective analysis of the clinical data of 30 patients with cervical spondylotic radiculopathy admitted to the Pain Department of Taihe Hospital Affiliated with Hubei Medical University from January 2021 to March 2024 was performed. During surgery, motor electrical stimulation was used to induce movement in the nerve-innervated area, and the relationship between the puncture needle tip and the cervical DRG position was verified using a C-arm X-ray machine. The numerical rating scale (NRS) was used for preoperative and postoperative pain assessment, clinical treatment effectiveness was evaluated, surgical duration and the associated complications were also recorded. Thirty patients exhibited clear cervical DRG images under ultrasound guidance, and the punctures were successful in all patients. Motor electrical stimulation induced movement in the corresponding nerve innervation area in the range of 0.3-0.8 mv in all patients. No serious complications occurred during the procedure. The transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of joint column for radiofrequency treatment is effective, convenient, and safe.

Evaluation of the efficacy of ultrasound-guided selective cervical nerve root pulsed radiofrequency treatment in patients with chronic cervical radicular pain.

Management of cervical radicular pain is complex and may be resistant to conservative treatment. The primary aim of this study was to evaluate the efficacy of ultrasound-guided selective cervical nerve root pulsed radiofrequency (US-SCNR PRF) treatment in patients with radicular neck pain due to cervical disc herniation who did not respond to conservative treatment. The secondary aim was to determine the efficacy of the treatment in terms of functionality, neuropathic pain, and treatment-related adverse events. This study included 62 patients with chronic cervical radicular pain who underwent US-SCNR PRF treatment. Pain intensity was assessed using the Numerical Rating Scale before treatment and at 1, 3, and 6months after treatment. The Neck Disability Index and Douleur Neuropathique 4 Questions were used to assess functionality and neuropathic pain before and 6months after treatment. Significant pain relief was defined as ≥ 50% reduction in the pain score compared with the pre-treatment score. Cervical radicular pain was significantly reduced at 1, 3, and 6months after pulsed radiofrequency compared to pre-treatment (P < 0.001). Successful pain relief was achieved in 59.6% of the patients at 6month. However, there was no significant difference between the mean pain scores in the 1st month, 3rd month and 6th month. In addition, the functionality and neuropathic pain scores were significantly reduced at 6month. These results suggest that US-SCNR PRF treatment is effective for cervical radicular pain, functionality, and neuropathic pain for at least six months in the majority of patients with refractory cervical radicular pain, and is considered a safer and preferable treatment modality due to real-time visualization of the cervical nerve roots and adjacent neurovascular structures and no radiation exposure.

Radiofrequency Improves Facial Fine Lines by Thermal Effect: Damage or Just Stimulation?

Radiofrequency (RF) has been widely used for rejuvenation treatments, but without knowledge of the effective temperature of the target tissues or guidance on treatment parameters, it often leads to adverse reactions and pain. The aim of this study was to demonstrate that thermal stimulation can produce facial rejuvenation effects and to determine the optimal bipolar RF treatment parameters for treating facial fine lines. A bipolar RF device combined with CORE Technology was used in this study. Exvivo studies were conducted on both miniature swine and human skin, utilizing thermographic thermometry and histological analysis. Invivo swine studies were conducted using histological analysis and electron microscopy. A clinical trial was conducted, and the results were evaluated using the Alexiades Comprehensive Grading Scale (ACGS) and Global Aesthetic Improvement Scale (GAIS) scales. The bipolar RF technology can produce a significant effect by thermally stimulating collagen within just 2 weeks without causing thermal damage. A clinical trial involving 46 patients showed a noticeable rejuvenating effect of the bipolar RF device, especially on fine wrinkles. This study confirmed that thermal stimulation, rather than thermal damage, is sufficient to achieve rejuvenation effects. The study also found a range of bipolar RF treatment parameters that are both safe and effective for facial fine lines.

Evaluation of the efficacy of ultrasound-guided maxillary and mandibular nerve pulsed radiofrequency treatment for trigeminal neuralgia and factors associated with successful response: a retrospective study.

This study aimed to investigate the treatment efficacy and clinical and demographic characteristics affecting treatment success in patients who underwent ultrasound (US)-guided pulsed radiofrequency (PRF) to the maxillary and/or mandibular nerves for trigeminal neuralgia. The data of patients with trigeminal neuralgia who underwent US-guided maxillary and/or mandibular nerve PRF between September 2022 and December 2023 were reviewed and the study was retrospectively designed. Good analgesia was defined as ≥ 50% reduction in pain score at 3 months after the procedure, and the demographic and clinical characteristics of the patients were assessed. Among the 72 included patients, 39 (54.2%) and 33 (45.8%) were classified as responders and non-responders, respectively. The age, pre- and post-procedural Numerical Rating Scale (NRS) scores, pain duration, and presence of constant pain were significantly lower in the responders. Logistic regression analysis revealed that older age (OR = 0.899, p < 0.001), high pre-procedural NRS scores (OR = 0.177, p = 0.009) and non-idiopathic (secondary or classic) etiology (OR = 0.062, p = 0.048) were significantly associated with an unsuccessful response to maxillary/mandibular PRF treatment. This study is the first clinical trial to evaluate the efficacy of PRF therapy of the maxillary and mandibular nerves in the treatment of trigeminal neuralgia and demonstrated a significant reduction in pain scores at 3 months. Older age, high pre-procedural NRS scores, and non-idiopathic (secondary or classical) etiology are independent predictors of poor response to ultrasound-guided maxillary/mandibular nerve pulse radiofrequency treatment.

Regulating the structure and gelling properties of maize starch by non-thermal effect of low intensity radio frequency wave

To verify whether there is a non-thermal effect in the radio frequency (RF) treatment process, it's very important for effectively excluding the thermal effect. Native maize starch (MS) slurry was treated under a specific electric field intensity while maintaining the sample temperature at 25 ± 2 °C for different times (1, 2, 4 and 8 h), which would effectively eliminate the influence of thermal effect on starch. A corresponding low electric field intensity of 3.3–3.4 kV/m was established after adjusting the electrode gap to be 220 mm of the 27.12 MHz RF system. Samples treated without RF-wave for the same time (1, 2, 4 and 8 h) were used as controls. The differences between the effect of these two treatments on the multi-scale structural and gelling properties of starch samples were investigated. Results showed that the low intensity RF-wave treatment enhanced the short-range structural order. A higher degree of order value and the double helical structure were observed from Fourier transform infrared (FTIR) spectra and solid state 13C nuclear magnetic resonance (13C NMR). Moreover, compared to control MS, the crystallinity of low intensity RF-treated starch significantly increased though the crystal pattern remained unchanged. Low intensity RF-wave treated starch had no significant difference in loss modulus, energy and distance of inter-double helices hydrogen bond, and pasting properties (i.e. TV, SB and BD) when compared with control sample. The effect of low intensity RF wave on starch without heating was insufficient to cause macroscopic property changes. These results provide valuable insights into the structural changes of starch treated by low intensity RF-wave and verify that the non-thermal effect of RF waves may be primarily achieved through the dipole polarization mechanism.

Our Single Center Experience in Osteoid Osteoma Patients Treated with CT-Guided Percutaneous Radiofrequency Ablation Treatment and Follow-up.

Introduction Osteoid osteoma (OO) is a painful benign bone tumor. Typically, it causes pain that is most noticeable during the night, which is improved by nonsteroidal anti-inflammatory drugs. In the treatment of symptomatic lesions, open surgery for nidus removal is the gold standard. However, surgical technical difficulties and morbidities vary by location. Percutaneous radiofrequency ablation (RFA) therapy guided by computed tomography (CT) is now a popular treatment option for OO. This study aims to assess our single-center experience with the technique, complications, and procedure effectiveness. Materials and Methods The study included fifteen patients who were treated between 2017 and 2021. A retrospective analysis was carried out on archive images and file records. The lesions' location, nidus width, and affected area (cortical, medullary) were all recorded. The procedure and technical success, as well as postoperative complications and the need for repeat ablation, were all documented. Results A total of 20 patients, 18 men, and 2 women, were included in the study, and 12 of them were pediatric patients. The patients' mean age was 16.9±7.3 years old, and the mean nidus diameter was 7.1±8.7 mm. There were 13 cortical niduses, 2 intramedullary niduses, and 5 corticomedullary niduses. The lesions were in the femur (n=12), tibia (n=6), scapula (n=1), and vertebrae (n=1). Two recurrences (10%) were observed in our patients during the follow-up. Patient with a femoral OO, the pain started again 12 weeks after the procedure and we performed additional RFA. The patient with vertebral OO had fewer symptoms and full recovery was not achieved. Therefore, the vertebral OO was ablated again 4 months later, and clinical success was achieved. One patient had a minor burn at the entry site that went away on its own after a short period of time. Except for the patient who was scheduled for a repeat RFA, no recurrence has been observed so far. The primary and secondary success rates are, respectively, 90% (18/20) and 100% (20/20). Conclusion RFA has a high success rate in treating OO. The procedure failure and recurrence rates are low. There are possibilities for posttreatment pain relief, early discharge, and a quick return to daily life. For inappropriate lesion localization, the RFA process replaces surgical treatment. The procedure-related complication rate is low. On the other hand, the burn during the procedure can be a serious problem.

Enhancing waste sludge solubilization through radio frequency treatment perforating bacterial cells

Sludge solubilization is known as a rate-limiting step of anaerobic digestion. Although radio frequency (RF) has been applied for sludge pretreatment due to its similar thermal effect as microwave, the potential non-thermal effects of RF treatment remain controversial. In this study, we demonstrate that RF pretreatment enhances the solubilization and lysis of sludge by 8.02%–19.69% through both thermal and non-thermal mechanisms with less energy input. Scanning electron microscope images provide direct evidence that RF-induced microcurrents penetrated bacterial cells, leading to the release of intracellular substances through formed pores. Additionally, the non-thermal effect of RF treatment which could weaken the cell protection and accelerate the lysis rate involves the disruption of binding forces between extracellular polymeric substances and microbial cells. On average, the utilization of RF at a frequency of 27.12 MHz demonstrates its efficacy as a sludge pretreatment technique, as evidenced by a 13.39% reduction in energy consumption and a 16.9% improvement in treatment performance compared to conductive heating (CH). The findings of this study elucidate the possible mechanism of RF treatment of sludge and could establish a theoretical basis for the practical application of RF treatment in sludge management.

Energy-Based Device Management of Nodular Reaction Following Poly-D, L-Lactic Acid Injection for Tear Trough Rejuvenation.

Poly-D,L-lactic acid (PDLLA) is used for tear trough rejuvenation but can cause complications like nodular reactions. This report describes using a radiofrequency device to manage these nodules. A 42-year-old woman developed firm, non-inflammatory nodules 3 weeks after receiving PDLLA (Juvelook) injections in the tear trough area. The nodules were firm and not associated with erythema or tenderness. The monopolar radiofrequency device was used directly on the nodules with 150 shots at an energy level 115 J, 28.75 J/cm². The treatment resulted in complete resolution of the nodules within 24 hours. The radiofrequency treatment effectively resolved the nodular reaction without recurrence, highlighting the device's compatibility with the unique structure of Juvelook's PDLLA. Radiofrequency therapy is effective for managing nodular reactions following PDLLA injections. Further research is needed to optimise protocols and improve the safety of biostimulator treatments in cosmetic procedures.

Conventional versus high-voltage, long-term pulse Radiofrequency of ganglion impar in perineal pain with advanced rectal cancer: a Randomized, double-blind controlled trial

Study objectiveAdvanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectiveness and safety of conventional radiofrequency (CRF) and high-voltage long-term pulsed radiofrequency (H-PRF) of radiofrequency therapy in the management of perineal pain in advanced rectal cancer.DesignRandomized, Double-Blind Controlled Trial.SettingSichuan Cancer Hospital & Institute and Yanjiang District People’s Hospital in Sichuan, China.ParticipantsA total of 72 patients with advanced rectal cancer experiencing perineal pain who were accepted for radiofrequency treatment.InterventionsPatients were assigned randomly (1:1) assigned to either the group CRF or H-PRF in a double-blind trial.Measurements and main resultsThe primary focus was on assessing perineal pain using numeric rating scales (NRS) scores at various time points. Secondary outcomes included the duration of maintaining a sitting position, depression scores, sleep quality, consumption of Oral Morphine Equivalent and Pregabalin, and the incidence of perineal numbness. A total of 57 patients (28 patients in the group CRF and 29 patients in the group H-PRF) were investigated. At all observation time points postoperatively, both groups of patients exhibited significant reductions in pain, enhancements in depression, improvements in sleep quality, and increased duration of sitting compared to their baseline measurements (P<0.05). During the 3 months and 6 months follow-up period, the group CRF exhibited significant reduction in pain, improvement in depression, sleep quality, and increased the time of keeping a sitting position compared with the group H-PRF (P<0.05). The consumption of oral morphine equivalent and Pregabalin as well as the incidence of perineal numbness were not significantly different between groups (P > 0.05).ConclusionOur results demonstrate that application of CRF and H-PRF in ganglion impar to reduce perineal pain and improve the quality of life of patients with advanced rectal cancer is safe and effective. However, the long-term effect of CRF is better compared with that of H-PRF.Trial registrationhttps://www.chictr.org.cn/ (ChiCTR2200061800) on 02/07/2022. This study adheres to CONSORT guidelines.

Effectiveness of combining greater occipital nerve block and pulsed radiofrequency treatment in patients with chronic migraine: a double-blind, randomized controlled trial

BackgroundPulsed radiofrequency (PRF) treatment targeting the greater occipital nerve (GON) has shown efficacy in treating various conditions. This double-blind, randomized controlled study aimed to evaluate the effects of combining PRF therapy with GON block (GONB) therapy in patients with chronic migraine.MethodsThe study consisted of two groups: GONB and GONB + PRF, each comprising 16 patients with chronic migraine. Using 0.5-Hz sensorial stimulation, a 5-cm-long radiofrequency needle was inserted under ultrasound guidance in both groups. Subsequently, all patients received a GONB by administering 2 mL of 0.25% bupivacaine. In the GONB + PRF group, patients underwent 4 min of PRF at 42℃, whereas the GONB group did not receive any PRF treatment. Follow-up examinations were performed at 1, 2, 3 and 6 months after the procedure to evaluate the frequency and severity of migraine attacks, number of headache days, and analgesic consumption.ResultsIn the GONB + PRF group, the visual analog scale (VAS) score, number of migraine attacks, number of headache days, and analgesic consumption were significantly lower compared to the GONB group (P < 0.05). Significant decreases (60%) in mean VAS scores, number of migraine attacks, number of headache days, and consumption of analgesic medications were observed in the GONB + PRF group at the 1-, 2-, 3-, and 6-month follow-ups compared with the pre-treatment period (P < 0.05).ConclusionsThe combination of GONB and PRF presents a promising new treatment option for patients with chronic migraine. This approach has demonstrated efficacy in minimizing analgesic use, decreasing the frequency of migraine attacks, reducing the number of headache days and decreasing the severity of migraine attacks.Trial RegistrationNCT05464212.