Pregabalin versus Pulsed Radiofrequency of Dorsal Root Ganglion for Treatment of Chronic Post Thoracotomy Pain Syndrome

Abstract

Background: After thoracotomy surgery, 50% of patients suffer chronic pain, which interferes with their day life activities and decrease their quality of life. The primary purpose of this research was to investigate the effects of oral Pregabalin and dorsal root ganglion [DRG] pulsed radiofrequency [RF] in the treatment of chronic post-thoracotomy pain [CPTP]. In addition, evaluation of the degree of neuropathic pain, the requirement for rescue analgesia and the total amount of paracetamol and piroxicam administered are secondary aims. Patients and Methods: Thirty participants were divided into two equal groups. Group A received oral Pregabalin with a dose ranging from 75 to 300 mg twice daily. Group B was subjected to pulsed RF of DRG. Visual analogue scale [VAS] score, Leeds Assessment of Neuropathic Symptoms and Signs scale [LANSS] score, the total amount of paracetamol and piroxicam used and side effects were assessed at 2 weeks, 1, 2 and 3 months, respectively. Patient satisfaction was assessed at the end of the study.Results: The obtained results showed that VAS score was lower in the RF group than Pregabalin group with P values of 0.001, 0.006, 0.01 and 0.167 at 2 weeks, 1, 2 and 3 months, respectively. The RF group had a lower mean LANSS score at 2 weeks and 1 month, but the ratio was reversed at 2 and 3 months. The used total amount of paracetamol and piroxicam were lower in the RF groups. In addition, patients in the RF group developed hypoesthesia in the corresponding dermatome, while in the Pregabalin group suffered dizziness, somnolence and balance disorders. At the end of the study, patients were more satisfied with RF treatment compared to Pregabalin one.Conclusion: Patients treated with pulsed RF had significant reduction in pain scores, less rescue analgesia consumed, tolerable side effects and were more satisfied with the treatment modality as compared to Pregabalin treated patients.

Keywords

• chronic post-thoracotomy pain
• pregabalin
• pulsed radiofrequency