Study of Chemical Neurolysis, Radiofrequency Ablation and Combined Radiofrequency with Chemical Neurolysis of Lumbar Sympathetic Ganglion in Peripheral Vascular Diseases of the Lower Limbs Volume 3 - Issue 3

Kalpana R Kulkarni¹* and Rajendra M Kulkarni²

• ¹Prof. & HOD (Dept. of Anaesthesia and Pain Management), DY Patil Medical College, Kolhapur MH, India
• ²Prof. & HOD (Dept. of Surgery), DY Patil Medical College, Kolhapur MH, India

Received: May 27, 2020;  Published: June 11, 2020

Corresponding author: Kalpana R Kulkarni, Prof & HOD (Dept. of Anaesthesia and Pain Management), DY Patil Medical College, Kolhapur MH, India

DOI: 10.32474/GJAPM.2020.03.000163

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Abstract

Background: Peripheral vascular diseases (PVDs) associated with atherosclerosis, hypertension, diabetes, thromboembolism, chronic regional pain syndrome or Berger’s disease, presents with ischemic manifestations of cold limbs, claudication, ulcers, or gangrene. Chemical lumbar sympathetic block (LSGB) with alcohol/ phenol and radiofrequency ablation (RF) are well-established methods to improve the circulation.

Methods: We conducted prospective observational study in 150 cases of PVDs who underwent chemical LSGB using 5ml of phenol 8% at two levels L2 and L3 under guidance of fluoroscopy (Group CH, n=50), RF ablation of lumbar sympathetic ganglions at L2 and L3 level (Group RF, n=50) and combined RF with chemical LSGB using phenol 5ml 8% at L2and L3level following RF(Group RF+CH, n=50).

Results: There was significant difference in VAS scores at six months of follow up in Group CH Vs Group RF+CH and Group RF Vs Group RF+CH, (mean VAS 2.2 in Group CH, 1.94 in Group RF & 1.26 in Group RF+CH,P <0.001) The mean WD improved significantly at six months in Group RF and RF+CH when compared with Group CH (P<0.001). At six months the temperature rise in affected limb/toe noted was 2.6 in Group CH, 2.76 in Group RF and 2.76 ̊C in Group RH +CH, it was significant for Group CH Vs RF+CH, P<0.05.

Conclusion: We observed significant reduction in VAS score, increase in WD and rise in temperature of the limb in all the groups, but longer lasting effects seen in combined technique in Group RF+CH as compared to sole RF or chemical LSGB.

Keywords: Gangrene, Peripheral vascular diseases, Lumbar sympathetic ganglion block, Chemical neurolysis, Radiofrequency ablation

Abstract| Introduction| Material & Methods| Results| Conclusion| Conflict of Interest| Source of Support| Acknowledgement| References|