Interventional therapy latest method in pain management
Radiofrequency Ablation is established in chronic pain but the use in cancer pain is practised only by a few centres worldwide.
It is done under local anaesthesia in the operation theatre and the patient is fully awake during the procedure.
Pain, amongst all medical complaints, is the most often reported complaint by a patient coming to a hospital. Whether a patient is having a painful recovery after a roadside trauma accident or is suffering from a postoperative pain or it is an irritating nerve pain – pain is the most frequently reported symptom by almost all patients. Usually, pain is treated by conventional medical modalities and if not responding, neuroablative interventional pain therapy comes as the latest addition to the treatment ladder.
Dr Ramji Swaminathan, specialist anaesthesia, heading the pain clinic at New Medial Centre, said: “Discussing pain, the most debilitating one is that suffered by a cancer patient; and conventionally, uncontrolled pain has been treated by injections of phenol to the nerves or nerve plexuses (network of nerves) that supplies blood to the affected area (also called chemical neurolysis). But Radiofrequency Ablation (also called thermal neurolysis), a method whereby heat is generated around the nerves thereby disabling the capacity of them to send signals of pain to the brain of the same nerves or plexuses, is slowly replacing the chemical neurolysis as it produces more controlled and precise impact.”
Radiofrequency Ablation is established in chronic pain but the use in cancer pain is practised only by a few centres worldwide. This option was used because it offers a longer duration of pain relief, of about a year and a half, as compared to chemical neurolysis with fewer side effects related to the procedure. It is done under local anaesthesia in the operation theatre and the patient is fully awake during the procedure.
Dr Ramji treated his first patient called Maria Josefina, a 32-year-old female patient, a known case of advanced cervical cancer, who is currently undergoing chemotherapy under Dr Mohanad Diab, head of oncology, NMC Specialty Hospital, Abu Dhabi, and had previously received conventional pain management options, was admitted with complaints of severe pain in the lower part of the body and had been receiving narcotics but with little to moderate effect.
“After assessment of the patient, we explained the various neuroablative procedures, like Radiofrequency Ablation, for managing cancer pain. Normally neurolytic procedures using phenol are performed for advanced cancer pain. As the patient was not getting any relief out of such conventional therapies, she was explained with the option of Radiofrequency Ablation,” added Dr Ramji.
After seven weeks, the patient had a pain score of around 2/10 and she is only on occasional pain relievers. She is now able to go about her daily routines more comfortably, no other complications reported and has an improved quality of life.