Ultrasound guided versus fluroscopic guided pulsed radiofrequency therapy of the stellate ganglion in neuropathic pain: A prospective controlled comparative study

Objective

To assess the efficacy and safety of fluoroscopic–guided versus ultrasound (US)-guided techniques for pulsed radiofrequency (RF) therapy of stellate ganglion for refractory neuropathic pain syndromes.

Methods

40 patients with severe chronic neuropathic pain syndromes, Visual Analogue Scale (VAS) score?>?7, with poor response to medical treatment were randomly integrated into 2 groups: Group (F): (20 patients) in whom pulsed R.F. therapy is done under fluoroscopy, group (U): (20 patients) in whom pulsed R.F. therapy is done under US guidance.

Results

The current study revealed that there is significant reduction of VAS, and of the medical treatment consumption after the block as compared with pre block values, there is no statistically significant difference between the guidance techniques of RF treatment in pain relief. However, the procedure time was significantly lower in U group.

Conclusion

Pulsed R.F. blockade of the stellate ganglion in patients with refractory neuropathic pain syndromes can be done safely and efficiently under the guidance of either ultrasound or fluoroscopy. Both radiological techniques provide similar satisfactory guidance without significant complications.