Adhesive Capsulitis, Impingement Syndrome, Rotator Cuff Impingement Syndrome, Rotator Cuff Injuries, Shoulder Pain
Conditions
Keywords
shoulder pain, Pulsed radiofrequency, Bipuvacaine, Nerve block
Brief summary
Comparative study between pulsed radiofrequency in suprascapular nerve or bupivacaine block for chronic shoulder pain
Detailed description
Prospective, randomized, comparative study of 40 participants with chronic shoulder pain allocated into two groups. Patients in group 1 underwent pulsed RF (180sec, with a fixed temperature at 42C, twice) on the suprascapular nerve, and the other group, 2, underwent nerve block with bupivacaine (5ml). After the procedure, patients were evaluated for 3 months regarding pain intensity, shoulder range of motion and dose of rescue opioids.
Interventions
DRUGSuprascapular nerve block with bipuvacaine
Suprascapular nerve block with Bipuvacaine: a 50mm 22G needle (Stimuplex, BBraun) was introduced up to the suprascapular fossa, guided by ultrasound, and the location was confirmed by motor stimulation with contraction of the supraspinatus and infraspinatus muscles. Next, 5 ml of 0.25% bupivacaine with adrenaline was injected.
PROCEDUREPulsed radiofrequency
After confirming the location, the needle mandrel was removed and the radiofrequency cannula was introduced through the needle, 2ml of 1% lidocaine without epinephrine was injected, followed by application of pulsed radiofrequency for 180sec at 42°C by radiofrequency (radiofrequency generator system BMS-50N, Bramsys).
Sponsors
Federal University of São Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Participants were allocated to groups using a random sequence of numbers generated by computer using the Randomizer® program (www.random.org). The number of patients and the groups to which they would belong were randomly drawn. These numbers were placed in envelopes numbered from 1 to 40, which were drawn on the day of the consultation.
Intervention model description
Group 1 - pulsed radiofrequency Group 2 - bupivacaine
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* Age over 18 years old * Chronic shoulder pain (more than 3 months) * Clinical and imaging diagnosis: rotator cuff injury, adhesive capsulitis, supraspinatus, tendinopathy, bicipital tendinitis, impingement syndrome, subscapularis tendinopathy, , subacromial and subdeltoid arthrosis, acromioclavicular arthrosis, subdeltoid subacromial bursitis * Pain intensity ≥4 on movement, on a numerical scale from zero to 10 (where zero means no pain and 10 the most intense pain imaginable).
Exclusion criteria
* Arrhythmia * Cognitive change (inability to answer questions) * Psychiatric illness * Infection at the site of the procedure * Coagulopathy, * Use of anticoagulants * Hypersensitivity to medications * Pregnant * Use of pacemaker
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of pain intensity after application of pulsed RF in the suprascapular nerve versus injection of a local anesthetic. | 12 months | Comparison of pain intensity after application of pulsed RF to the suprascapular nerve and after injection of a local anesthetic. The numerical pain scale (Visual Analogue Scale - VAS) at rest and during movement was used. This scale (VAS) ranges from 1 to 10, with 1 representing mild pain and 10 representing severe pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To assess the range of motion of the shoulder joint | 12 months | To assess the range of motion of the shoulder joint. A goniometer was used to assess the range of motion. |
| Need for additional analgesic. | 12 months | Assessment of the need for additional analgesics according to pain. Pain was measured using the Visual Analogue Scale, ranging from 1 to 10, with 1 representing mild pain and 10 representing severe pain. |
| Duration of the analgesic effect. | 12 months | Pain was assessed using the numerical pain scale (Visual Analogue Scale - VAS). The participant was asked to respond on a scale of 1 to 10, with 1 representing mild pain and 10 representing severe pain. |
Countries
Brazil
Outcome results
None listed