Pulsed Radiofrequency of Shoulder Individual Nerves Versus Brachial Plexus in Management of Chronic Post Mastectomy Shoulder Pain

Cairo University90 enrolled

Overview

this study aims to assess the role of pulsed radiofrequency of the brachial plexus or pulsed radiofrequency of shoulder individual nerves in the management of post-mastectomy shoulder pain.

Breast cancer is the second most common cancer world-wide following lung cancer. It afflicts about 1.7 million patients annually, of which 60% mandate surgery of the breast and/or the axilla, and nearly 20-50% of them may develop post-mastectomy pain syndrome. Regarding pulsed RF of the brachial plexus, it is not tried up till now for shoulder pain. Since C 5,6,7 are derived from upper and middle trunks of brachial plexus, then innervation of shoulder joint can be blocked by interscalene brachial plexus block or pulsed radiofrequency . Review of literature demonstrated efficacy of PRF of brachial plexus in case studies for other conditions e.g. pain associated with a tumor involving the brachial plexus , refractory stump pain , chemotherapy-induced peripheral neuropathy of the upper limb and radiation-induced brachial plexopathy .

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Pulsed Radiofrequency Shoulder Individual Nerves Brachial Plexus Chronic Post Mastectomy Shoulder Pain

Interventions

Brachial plexus pulsed radiofrequencyOTHER

Patients will receive pulsed radiofrequency of brachial plexus with steroids injection.

Sholder individual nerves pulsed radiofrequencyOTHER

Patients will receive shoulder individual nerves pulsed radiofrequency with steroids injection.

ControlOTHER

Patients will receive conservative treatment (paracetamol 1000 tid and pregabalin 75 mg bid; can be increased to 150 mg bid , oxycodone 10 mg oral every 12 hrs .

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age (18-65) Years. * American Society of Anesthesiologists (ASA) physical status (II- III). * Patients with post mastectomy shoulder pain. * Body mass index (BMI): (20-40) kg/m2. * Patients on maximum daily dose tramadol ( 450mg ) and still in pain Exclusion Criteria: * Patient refusal. * Known sensitivity or contraindication to drugs used in the study. * Pregnancy. * Recent myocardial infarction. * Hemodynamically unstable. * Local and systemic sepsis. * Psychiatric illness.

Locations (1)

Cairo University

Cairo, Egypt

RECRUITING

Outcomes

Primary Outcomes

Changes in visual Analogue Scale (VAS )

Changes in visual Analogue Scale (VAS )for assessment of pain relief. A 100 mm horizontal line version will be used with 2 ends (left-end means no pain and right-end means the worst pain). This version is preferred in research studies for chronic pain status.