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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Sacroiliac joint pain: Prospective, randomised, experimental and comparative stu...
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Vol. 63. Issue 5.
Pages 267-272 (May 2016)
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Vol. 63. Issue 5.
Pages 267-272 (May 2016)
Original article
DOI: 10.1016/j.redare.2015.12.001
Sacroiliac joint pain: Prospective, randomised, experimental and comparative study of thermal radiofrequency with sacroiliac joint block
Dolor en la articulación sacroilíaca: estudio prospectivo, aleatorizado, experimental y comparativo de la radiofrecuencia térmica con el bloqueo de la articulación sacroilíaca
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L. Cánovas Martíneza,
Corresponding author
, J. Orduña Vallsa, E. Paramés Mosqueraa, L. Lamelas Rodrígueza, S. Rojas Gila, M. Domínguez Garcíab
a Unidad de Dolor, Servicio de Anestesia, Reanimación y Dolor, Complexo Hospitalario Universitario Ourense (CHUO), Ourense, Spain
b Unidad de Dolor, Hospital Insular de Lanzarote, Arrecife, Las Palmas, Spain
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Tables (4)
Table 1. Level of evidence for interventional techniques in the treatment of sacroiliac joint pain.
Table 2. Diagnostic tests for sacroiliac joint pain.
Table 3. Patient demographics (age, sex, weight and cause of pain).
Table 4. Analgesic efficacy rated on VAS (comparison between means over baseline in each group) and comparison with VAS at 12-month follow-up in all 3 groups.
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Abstract
Objective

To compare the analgesic effects between the blockade and bipolar thermal radiofrequency in the treatment of sacroiliac joint pain.

Method

Prospective, randomised and experimental study conducted on 60 patients selected in the two hospitals over a period of nine months, who had intense sacroiliac joint pain (Visual Analogue Scale [VAS]>6) that lasted more than 3months. Patients were randomised into three groups (n=20): Group A (two intra-articular sacroiliac injections of local anaesthetic/corticosteroid guided by ultrasound in 7days). Group B: conventional bipolar radiofrequency “palisade”. Target points were the lateral branch nerves of S1, S2, and S3, distance needles 1cm. Group C: modified bipolar radiofrequency “palisade” (needle distance >1cm). Patients were evaluated at one month, three months, and one year. Demographic data, VAS reduction, and side effects of the techniques were assessed.

Results

One month after the treatment, pain reduction was >50% in the three groups p<.001. Three and 12months after the technique, the patients of the Group A did not have a significant reduction in pain. At 3 months, almost 50% patients of the Group B referred to improvement of the pain (p=.03), and <25% at 12months, and those results were statistically significant (p=.01) compared to the baseline. Group C showed an improvement of 50% at 3 and 12months (p<.001). All patients completed the study.

Conclusions

Bipolar radiofrequency “palisade”, especially when the distance between the needles was increased, was more effective and lasted longer, compared to join block and steroids, in relieving pain sacroiliac joint.

Keywords:
Pain
Intra-articular block
Radiofrequency denervation
Palisade
Sacroiliac joint
Bipolar
Resumen
Objetivo

Comparar el bloqueo con la radiofrecuencia térmica bipolar para el dolor de la articulación sacroilíaca.

Método

Estudio prospectivo, aleatorizado y experimental en 60 pacientes, seleccionados en 9 meses en 2 centros, con dolor intenso (escala visual analógica [EVA]>6) de >3meses de duración. Fueron divididos en 3 grupos (n=20). GrupoA: pacientes a los que se les realizaron 2 bloqueos intraarticulares, con control ecográfico en 7 días. GrupoB: radiofrecuencia bipolar «palisade» utilizando 6 agujas perpendiculares a la zona dorsal del sacro, a una distancia de 1cm, para producir lesiones contiguas entre los forámenes S1-S2-S3 y la línea articular. Grupo C: radiofrecuencia bipolar «palisade» modificada (distancia entre agujas >1cm). Los pacientes fueron evaluados al mes, a los 3 y a los 12 meses del tratamiento. Se valoraron los datos demográficos (en la visita basal), la eficacia analgésica y los efectos secundarios (en el resto).

Resultados

Al mes, la reducción del dolor en los 3 grupos fue >50% (p0,001). A los 3 y 12meses el grupo A no refirió disminución significativa del dolor. El grupoB, a los 3meses, alivio cercano al 50% (p=0,03), y <25% (23,8) a los 12meses (p=0,01). En el grupo C, alivio próximo al 50% a los 3 y 12 meses (p<0,001) respecto al basal. Todos los pacientes finalizaron el estudio.

Conclusiones

La radiofrecuencia bipolar «palisade», especialmente aumentando la distancia entre las agujas, ha sido eficaz, a más largo plazo, que el bloqueo con anestésicos y corticoides en el alivio del dolor de la articulación sacroilíaca.

Palabras clave:
Dolor
Bloqueo intraarticular
Radiofrecuencia térmica
«Palisade»
Articulación sacroilíaca
Bipolar

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