Post-Mastectomy Chronic Pain Syndrome
Conditions
Brief summary
neuropathic pain can occur following any surgical procedure on the breast ..
Detailed description
chronic pain affects the daily lives of post-surgical breast cancer patients. many of these patients were undertreated for pain and generally obtained poor pain relief.treated patients with chronic thoracic segmental pain including patients with post-mastectomy pain syndrome by radiofrequency for dorsal root ganglion reported longterm pain relief.
Interventions
PROCEDUREradiofrequency
The procedure will be done under propofol sedation, under fluoroscopic guidance. The image intensifier will be rotated in a cephalo-caudal direction until the endplates of the thoracic vertebrae are aligned and the transverse processes became discernable from the ribs. For the intercostal nerve group, the radiofrequency needle 10 cm with 10 ml active tip will then inserted to contact the lower edge of the transverse process of (T2-T5), the needle is walked off to obtain sensory stimulation between 0.3-0.6 mv and motor stimulation less than 1.2 mv .five cycle of pulsed radiofrequency will be delivered.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients with chronic post-mastectomy pain for at least 3 months post operatively. * patients with visual analogue scale for pain score \> 4 * patients treated with more than one line of anti-neuropathic drugs.
Exclusion criteria
* patient refusal. * coagulopathy. * chest and back deformity. * infection at the introduction site of the needle .
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The intensity of pain | 1 month , 2 month and 3 month post-procedure | A Visual Analogue Scale is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. For example, the intensity of pain. Operationally a VAS is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end. The patient marks on the line the point that they feel represents their perception of their current state.The VAS score is determined by measuring in millimetres from the left handend of the line to the point that the patient marks. Scoring and interpretation : using a ruler, score is determined by measuring the distance(mm) on the10 cm line between the no pain anchor and the patient's mark ,providing a range of scores from (0\_100). A higher score indicates greater pain intensity. the following cut points on the pain VAS have been recommended: no pain (0-4 mm), mild pain(5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm) . |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The analgesics consumption | 1 month , 2 month and 3 month post-procedure | The change in analgesics consumption |
Countries
Egypt
Outcome results
None listed