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Pulsed radiofrequency treatment in CHRONIC pain syndromes

Pulsed radiofrequency treatment in CHRONIC pain syndromes. What is the evidence?. Introdução à Medicina I | Teacher José Gustavo Martins | Class 14. Summary. Introduction 1.1 Background and justification Motivation of the research What is pain ?

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Pulsed radiofrequency treatment in CHRONIC pain syndromes

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  1. Pulsed radiofrequency treatment in CHRONIC pain syndromes What is the evidence? Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  2. Summary • Introduction • 1.1Background andjustification • Motivationoftheresearch • Whatispain? • Painproblems (intheworldandin Portugal) • Chronicpain • Differenttreatments for chronicpain • PulsedRadiofrequencytreatment • 1.2Researchquestionandaims • 2. Methods • 3.ExpectedResults Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  3. 1.Introduction1.1 Background and justification Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  4. 1.Introduction1.1 Background and justification Whatispain? PAIN The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.“ (5) Acute Chronic Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  5. 1.Introduction1.1 Background and justification • Painproblemin Portugal andintheworld • Pain is the second leading cause of hospitalization • Early treatment of chronic pain enhances its control • In Portugal, a large proportion of cases are not addressed as early as recommended • A high percentage of people have experienced back pain • Plano Nacional de ControlodaDorseeks to improve the treatment of patients with pain syndromes. (7) Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  6. 1.Introduction1.1 Background and justification • Chronicpain • Chronicpainhasbeendefined as painthatpersistslongerthanthe temporal courseof natural healinganditisassociatedwith a particular typeofinjuryordiseaseprocess. (8) Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  7. 1.Introduction1.1 Background and justification Differenttreatments for chronicpain RelaxationTechniques PhysicalTherapy ElectricalStimulationTherapies Helpsreduce stress levels Relievespainandimprovesmovementandfunction Alterspainsignals as theytravel to thebrain • Of the most importance is to build a clear treatment plan for chronic pain, and part of it should be identifying ways for patients to manage their pain. • There is also medicines which can be administrated to relieve pain and inflammation, such as corticosteroids, acetaminophen, cooling sprays, opioid analgesics, or a therapy called nerve block therapy which is an anesthetic that is injected into the affected nerve to relieve pain. (9) Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  8. 1.Introduction1.1 Background and justification • A development of heat based radiofrequency denervation • To treat especially chronic pain • Minimally invasive target selective technique • Uses brief pulses of high voltage (Rf range – 300kHz) to produce controlled tissue destruction • Heat dissipates between pulses, avoiding thermocoagulation • Reduces pain by modullating pain transmission • Produces transient inibition of evoked synaptic activity (10) (11) Radiofrequencytreatment Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  9. 1.Introduction1.2 Research question and aims What is the evidence of published evidence about pulsed radiofrequency treatment in chronic pain syndromes? • Aims • To do a critical approach about published articles about the evidence of pulsed radiofrequency treatment in chronic pain syndromes • To know more about different types of chronic pain syndromes; • To know more about Pulsed radiofrequency treatment; • To understand why there is controversy about this subject. Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  10. 2. Methods • Type of study Systematic Review • Units of analysis Articles found in databases • Data Search PubMed ISI Web of Knowledge Scopus Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  11. 2. Methods • Key-words Pain Chronic Pulsed Radiofrequency • Query pulsed[All Fields] AND radiofrequency[All Fields] AND (("pain"[MeSH Terms] OR "pain"[All Fields]) AND chronic[All Fields]) • MeSHTerm: • Pain Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  12. 2. Methods PULSED RADIOFREQUENCY CHRONIC PAIN Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  13. 2. Methods • Research Limits Exclusion Criteria - Other types of articles, such as reviews, letters to editor or comments - Articles contemplating pulsed radiofrequency used not as a treatment for chronic pain syndromes - Articles which don’t mention the methods used or the results Inclusion Criteria - Language: English - No date of publication limits Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  14. 2. Methods FLOW CHART

  15. 2. Methods Work Fases • Formulation of a clear question: “Pulsed radiofrequency treatment in pain syndromes - What is the evidence?” • Definition of aims • Definition of methods • Databases’ research • Abstracts’ reading • Articles selection, by application of inclusion an exclusion criteria (each article should be read by two people. Divergences should be solved by consensus) • Analysis of the selected articles • Discussion of the results • Review article’s writing • Website’s building Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  16. 2. Methods Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  17. 3. Expected Results • To reassure the knowledge previously acquired mainly in subjects regarding scientific research tools and information selection. • To improve the quality of our research both in terms of knowledge and information, and also time. • To have a solid review about this subject. • To understand the different points of view about this subject. • Manage to present it correctly to the public. Introdução à Medicina I | Teacher José Gustavo Martins | Class 14

  18. Class 14 • ANA LUIS FARIA • INES PINTO • JORGE PINTO • JORGE SOARES • JOSE BARRETO • JOSE VICENTE FORMOSO • LUÍS OLIVEIRA • MAFALDA PINTO • MAFALDA PAIS CARRINGTON • MARIA TERESA SILVERIO • MARIA LEONOR GODINHO • MIGUEL VALENTE • PAULA TEIXEIRA • PEDRO MONTEIRO

  19. References • 1. van Boxem K, van Eerd M, Brinkhuize T, Patijn J, van Kleef M, van Zundert J. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence. 2008 Sep-Oct • 2. Racz, G.B, Ruiz-Lopez, R. Radiofrequency Procedures: Review Article, Pain Practice, 2006; p.46-50 • 3. Misra S, Ward S, Coker C.Pain. Pulsed radiofrequency for chronic testicular pain-a preliminary report, 19/03/2009, p.673-8 • 4. Byrd D, Mackey S. Curr Pain Headache Rep. Pulsed radiofrequency for chronic pain. 2008 Jan, p.37-41. • 5. Merskey, H; Bogduk N. Part III: Pain Terms, A Current List with Definitions and Notes on Usage, 1994, p 209 6. Glossaryofterms. Consultado em 23 de Dezembro de 2009, em Medicine Net: http://www.medicinenet.com/emotional_eating/glossary.htm • 7. Portal da Saúde. Consultado em 20 de Dezembro de 2009, em Ministério da Saúde: http://www.minsaude.pt/portal/conteudos/a+saude+em+portugal/noticias/arquivo/2008/6/controlo+dor.htm) • 8. Chronicpain. Consultado em 25 de Outubro de 2009, em emedicinehealth: http://www.emedicinehealth.com/chronic_pain/page2_em.htm • 9. Flannery, Jeanne. Rehabilitation nursing secrets, p.330 e 307 • 10. Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia Pain, Volume 104, Issue 3, Page 449 • 11. Pulsed radiofrequency for chronic back pain. Consultado em 29 de Outubro de 2009 em Themedical news: http://www.news-medical.net/news/2007/05/22/25417.aspx

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