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Tytuł:
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Efficacy and Safety of Pulsed Radiofrequency as a Method of Dorsal Root Ganglia Stimulation in Patients with Neuropathic Pain: A Systematic Review.
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Autorzy:
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Vuka I; Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.
Marciuš T; Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.
Došenović S; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Split, Split, Croatia.
Ferhatović Hamzić L; Department of Proteomics, Centre for Translational and Clinical Research, University of Zagreb School of Medicine, Zagreb, Croatia.
Vučić K; Department for Safety and Efficacy Assessment of Medicinal Products, Agency for Medicinal Products and Medical Devices, Zagreb, Croatia.
Sapunar D; Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia.; Centre for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
Puljak L; Centre for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
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Źródło:
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Pain medicine (Malden, Mass.) [Pain Med] 2020 Dec 25; Vol. 21 (12), pp. 3320-3343.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't; Systematic Review
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Język:
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English
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Imprint Name(s):
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Publication: 2016- : Oxford, England : published by Oxford University Press on behalf of the American Academy of Pain Medicine
Original Publication: Malden, MA : Blackwell Science, Inc., c2000-
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MeSH Terms:
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Neuralgia*/therapy
Neuralgia, Postherpetic*
Pulsed Radiofrequency Treatment*
Ganglia, Spinal ; Humans ; Pain Management
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Contributed Indexing:
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Keywords: Chronic Pain; DRG; Neuropathic Pain; PRF
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Entry Date(s):
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Date Created: 20200604 Date Completed: 20210514 Latest Revision: 20210514
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Update Code:
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20240104
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DOI:
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10.1093/pm/pnaa141
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PMID:
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32488240
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Objective: Pulsed radiofrequency (PRF) is a nonablative pain treatment that uses radiofrequency current in short high-voltage bursts, resulting in interruption of nociceptive afferent pathways. We conducted a systematic review with the aim to create a synthesis of evidence about the efficacy and safety of PRF applied to the dorsal root ganglion (DRG) for the treatment of neuropathic pain.
Methods: We searched MEDLINE, CINAHL, Embase, and PsycINFO through January 8, 2019, as well as ClinicalTrials.gov and the clinical trial register of the World Health Organization. All study designs were eligible. We assessed risk of bias using the Cochrane tool for randomized controlled trials and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I). We assessed level of evidence using the Oxford tool and quality of evidence with GRADE.
Results: We included 28 studies with participants suffering from lumbosacral, cervical, or thoracic radicular pain, post-herpetic neuralgia, neuropathicbone pain in cancer patients, or carpal tunnel syndrome. Only five studies were randomized controlled trials (RCTs), while others were of nonrandomized designs, predominantly before and after comparisons. A total of 991 participants were included, with a median number (range) of 31 (1-101) participants. Only 204 participants were included in the RCTs, with a median number (range) of 38 (23-62) participants. The overall quality of evidence was low, as the majority of the included studies were rated as evidence level 4 or 5. The quality of evidence was very low.
Conclusions: Evidence about the efficacy and safety of PRF of the DRG for the treatment of neuropathic pain is based mainly on results from very small studies with low evidence quality. Current research results about the benefits of PRF of the DRG for the treatment of neuropathic pain should be considered preliminary and confirmed in high-quality RCTs with sufficient numbers of participants.
(© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
