Pulsed radiofrequency for chronic inguinal neuralgia

Background: chronic inguinal neuralgia has been reported after inguinal herniorrhaphy,caesarean section,appendectomy,and trauma to the lower quadrant of the abdomen or inguinal region. objectives: this study was designed to evaluate the efficacy of pulsed radiofrequency in management of chronic inguinal neuralgia. study design: randomized,double-blind controlled trial. setting: hospital outpatient setting. methods: twenty-one patients were allocated into 2 groups. group 1 received 2 cycles of pulsed radiofrequency (prf) for each nerve root. in group 2,after stimulation,we spent the same time to mimic prf. both groups received bupivacaine 0.25% + 4 mg dexamethasone in 2 ml for each nerve root. visual analogue scale (vas) was assessed. duration of the first block effective pain relief was reported. repeated prf blockade was allowed for any patient who reported a vas > 30 mm in both groups during the one year follow-up period. the number and duration of blocks were reported and adverse effects were also reported. results: significantly longer duration of pain relief was noticed in group 1 (p = 0.005) after the first block,while the durations of pain relief of the second block were comparable (p = 0.59). in group 1 the second prf produced pain relief from the twenty-fourth week until the tenth month while in group 2,pain relief was reported from the sixteenth week until the eighth month after the use of prf. all patients in group 2 received 3 blocks (the first was a sham prf) during the one year follow-up period. meanwhile,2 prf blocks were sufficient to achieve pain relief for patients in group 1 except 4 patients who needed a third prf block. no adverse events were reported. limitations: small sample size. conclusion: for intractable chronic inguinal pain,prf for the dorsal root ganglion represents a promising treatment modality. © 2015,american society of interventional pain physicians. all rights reserved.