Anesthesiology and Pain
بیهوشی و درد
JAP
Medical Sciences
http://jap.iums.ac.ir
1
admin
2228-6659
2322-3324
000
000
000
000
000
fa
jalali
1391
7
1
gregorian
2012
10
1
3
3
online
1
fulltext
fa
مقایسه رادیوفرکانس پالس و بلوک شاخه مدیال در درمان دردهای کمری با منشأ مفصل فاست
Comparison of Pulsed Radiofrequency and Medial Branch Blockage in Controlling Facet-Originating Low Back Pain
عمومى
General
پژوهشي
Original
<p class="MsoNormal" dir="rtl" style="text-align: justify line-height: normal margin: 0cm 0cm 0pt unicode-bidi: embed direction: rtl"><strong><span 14pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">زمینه و هدف: </span></strong><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">استفاده از روش‏های رادیوفرکانس پالس و بلوک عصبی مفصل فاست</span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times=""><span style="mso-spacerun: yes"> </span>از جمله روش‏های مطرح شده در زمینه دردهای کمری با منشا مفاصل فاست هستند که در کلینیک درد برای مهار این نوع دردها مورد استفاده قرار می‏گیرند. در این مطالعه به مقایسه‏ی تأثیر دو روش رادیوفرکانس پالس و بلوک مفصل فاست در بهبود درد و ناتوانی حرکتی بیماران مبتلا به این­گونه دردها پرداخته می­شود.</span></p>
<p class="MsoNormal" dir="rtl" style="text-align: justify line-height: normal margin: 0cm 0cm 0pt unicode-bidi: embed direction: rtl"><strong><span 14pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">مواد و روش­ها:</span></strong><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times=""> 50 بیمار مشکوک به دردهای کمری با منشا مفصل فاست که پاسخ بلوک تشخیصی آن­ها <span style="mso-spacerun: yes"> </span>با 05/ 0میلی­لیتر لیدوکایین 2% در نواحی </span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">L1-L3</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times=""> و </span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">L3</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">-</span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">L5</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times=""> مثبت بود در دو گروه 25 نفری وارد مطالعه شدند. بیماران در گروه 1 با رادیوفرکانس پالس با درجه حرارت کمتر از 40 درجه و در گروه 2 به روش بلوک عصبی مفصل فاست تحت درمان قرار گرفتند. اطلاعات بیماران شامل سن، جنس، شدت درد (بر اساس </span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">VAS</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">)، میزان توانایی حرکتی (بر اساس </span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">ODI</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">) و نیز سطح رضایتمندی بیماران </span><span style="font-size: small"><span apos="" apostimes="" b="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: ">(</span><span 12pt="" apos="" apostimes="" b="" font-size:="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: ">براساس مقیاس دهگانه 0تا 10 </span><span apos="" apostimes="" b="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: ">(0=بد 10= عالی</span><span 12pt="" apos="" apostimes="" b="" font-size:="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: ">)) قبل از درمان و در هفته‏های 6 و 12 تعیین و با هم مقایسه شدند. </span></span></p>
<p class="MsoNormal" dir="rtl" style="text-align: justify line-height: normal margin: 0cm 0cm 0pt unicode-bidi: embed direction: rtl"><strong><span 14pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">یافته ها: </span></strong><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">در هفته­های 6</span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">و 12، درد و </span><span 12pt="" b="" fa="" font-size:="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times="">ODI</span><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times=""> بیماران در گروه رادیوفرکانس نسبت به گروه 2 بهبود معنی‏داری را نشان داد.</span></p>
<p class="MsoNormal" dir="rtl" style="text-align: justify line-height: normal margin: 0cm 0cm 0pt unicode-bidi: embed direction: rtl"><span 12pt="" font-size:="" mso-bidi-language:="" new="" style="font-family: " times="">)</span><span style="font-size: small"><span aposb="" dir="ltr" fa="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" font-size:="" lang="FA" mso-bidi-language:="" new="" style="font-family: " times="">05/0></span><span 12pt="" dir="ltr" font-size:="" mso-bidi-language:="" new="" style="font-family: " times=""> .(p</span><span 12pt="" apos="" apostimes="" b="" font-size:="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: "> سطح رضایت‏مندی بیماران در گروه رادیوفرکانس نیز در هفته‏های 6</span><span 12pt="" aposb="" dir="ltr" fa="" font-size:="" lang="FA" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" apos="" apostimes="" b="" font-size:="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: "><span style="mso-spacerun: yes"> </span>و 12 به نحو معنی‏داری بیش از گروه 2 بود.</span><span 12pt="" aposb="" dir="ltr" fa="" font-size:="" lang="FA" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span aposb="" dir="ltr" fa="" lang="FA" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""><span style="mso-spacerun: yes"> </span></span><span 12pt="" dir="ltr" font-size:="" mso-bidi-language:="" new="" style="font-family: " times="">)</span><span aposb="" dir="ltr" fa="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" font-size:="" lang="FA" mso-bidi-language:="" new="" style="font-family: " times="">05/0></span><span 12pt="" dir="ltr" font-size:="" mso-bidi-language:="" new="" style="font-family: " times=""> (p</span><span 12pt="" apos="" apostimes="" b="" font-size:="" lang="FA" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: ">. میزان مصرف مُسکن در گروه 1 در هفته­های 6<span style="mso-spacerun: yes"> </span>و 12 به نحو معنی‏داری کمتر از گروه 2 بود</span><span 12pt="" aposb="" dir="ltr" fa="" font-size:="" lang="FA" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span aposb="" dir="ltr" fa="" lang="FA" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""><span style="mso-spacerun: yes"> </span></span><span 12pt="" dir="ltr" font-size:="" mso-bidi-language:="" new="" style="font-family: " times="">)</span><span aposb="" dir="ltr" fa="" mso-bidi-font-family:="" mso-bidi-language:="" new="" style="font-family: " times=""> </span><span 12pt="" font-size:="" lang="FA" mso-bidi-language:="" new="" style="font-family: " times="">05/0></span></span><span 12pt="" font-size:="" mso-bidi-language:="" new="" style="font-family: " times=""> (p</span></p>
<p class="MsoNormal" dir="rtl" style="text-align: justify line-height: normal margin: 0cm 0cm 0pt unicode-bidi: embed direction: rtl"><strong><span 14pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">بحث و نتیجه گیری: </span></strong><span 12pt="" b="" font-size:="" mso-ascii-font-family:="" mso-bidi-language:="" mso-hansi-font-family:="" new="" style="font-family: " times="">رادیوفرکانس پالس با درجه حرارت کمتر از 40 درجه در کوتاه مدت نتایج درمانی قابل قبولی داشته و در بهبود درد و ناتوانی حرکتی بیماران بهتر از بلوک عصبی مفصل فاست عمل می­کند.</span></p>
<p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="font-size: small"><font face="Calibri"><strong><span style="mso-bidi-font-family: Nazanin">Background and aims:</span></strong><span style="mso-bidi-font-family: Nazanin"> Using methods such as pulsed radiofrequency (PRF) and nerve blocks are among the methods used in pain clinics to treat facet-originating low back pain. This study compares two methods of pulsed radiofrequency and facet joint block (FJB)regarding pain recovery and improving disability of patients suffering from facet-originating low back pain.</span></font></span></p>
<p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="font-size: small"><font face="Calibri"><strong><span style="mso-bidi-font-family: Nazanin">Material and Method</span></strong><span style="mso-bidi-font-family: Nazanin">: 50 patients with low back pain and positive response to diagnostic nerve block test with 0.5 ml of 2% lidocaine in L1-L3 and L3-L5 were included The patients were <span style="mso-spacerun: yes"> </span>randomly assigned to two groups of either pulsed radiofrequency at a temperature below 40 degrees or facet joint nerve block. Demographic data including age, sex, pain intensity (based on VAS), motor ability (based on ODI) and patient satisfaction (0 = none, 10= Excellent) before the treatment and at weeks 6 and 12 thereafter were recorded.</span></font></span></p>
<p class="MsoNormal" style="text-align: justify margin: 0cm 0cm 10pt"><strong><span style="mso-bidi-font-family: Nazanin"><span style="font-family: Calibri font-size: small">Findings:</span></span></strong><span style="mso-bidi-font-family: Nazanin"><span style="font-family: Calibri font-size: small"> Patients’ pain and ODI significantly improved in PRF group compared with FJB group at week 6 and 12 (p<0/05). Patients’ satisfaction in PRF group at week 6 and 12 was significantly more than the FJB group (p<0/05). Using analgesics in PRF group at week 6 and 12 was significantly lower than FJB group. (p<0/05)<br>
<br>
<strong>Conclusion:</strong> pulsed radiofrequency has short-term acceptable outcomes in comparison with facet joint nerve block, regarding pain recovery and ability.</span></span></p>
39
0
http://jap.iums.ac.ir/browse.php?a_code=A-10-25-28&slc_lang=fa&sid=1
MahmoodReza Moradkhani1, Sirous Moemenzadeh*2, Fatemeh Neematollahi3,
Farshad Hassanzadeh-Kiabi 4 SeyedSadjad Razavi5
محمود رضا مراد خانی، سیروس مومن زاده، فاطمه نعمت الله
فرشاد حسن زاده کیابی ، سیدسجاد رضوی
100319475328460013557
100319475328460013557
Yes