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Percutaneous splanchnic nerve radiofrequency ablation for chronic abdominal pain
Author(s) -
Garcea Giuseppe,
Thomasset Sarah,
Berry David P.,
Tordoff Simon
Publication year - 2005
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2005.03486.x
Subject(s) - medicine , radiofrequency ablation , percutaneous , anesthesia , splanchnic , celiac plexus , plexus , nerve block , pancreatitis , abdominal pain , surgery , ablation , hemodynamics
Background: Splanchnic nerve block is a useful alternative to coeliac plexus block in the management of patients with chronic upper abdominal pain. The predictable relationship of the splanchnic nerves to other structures allows for accurate needle placement and hence a low risk of iatrogenic damage. Radiofrequency ablation (RFA) uses a high frequency alternating current to heat tissues leading to thermal coagulation. It produces predictable and accurate lesions and hence is useful alternative to more conventional phenol and alcohol neurolytic methods. Methods: The present study examined a series of 10 patients undergoing percutaneous RFA splanchnic nerve blockade for chronic pancreatitis. Pain levels, anxiety, quality of life, daily activity, mood and interpersonal relationships were all assessed pre‐ and postprocedure, using a visual analogue score. Median follow‐up was 18 months (range: 12−24 months). Statistical analysis was undertaken using non‐parametric Wilcoxon matched pair analysis, statistical significance was set at the 95% confidence intervals. Results: Splanchnic nerve RFA not only led to a decrease in pain scores, opiate analgesia use and acute admissions for pain; but it also resulted in improvement of other parameters associated with long‐term debilitating chronic pain, such as anxiety levels, daily activity, overall mood and general perception of health. There were no major complications. All changes observed were statistically significant. Conclusion: Although preliminary data regarding RFA ablation of splanchnic nerves are encouraging, further trials are also needed comparing percutaneous splanchnic nerve ablation with opiod analgesia and coeliac plexus blockade.