EFFICACY AND SAFETY OF Pulsed radiofrequency treatment in CHRONIC pain syndromes

EFFICACY AND SAFETY OF Pulsed radiofrequency treatment in CHRONIC pain syndromes Introdução à Medicina II | Teacher Luís Filipe Azevedo | Class 14

Summary • Introduction • Methods • 3.Results • 4. Planninganddevelopmentoffuturetasks • 5.References Introdução à Medicina II | Teacher Luís Azevedo | Class 14

1.Introduction Research question and aims What is the efficacy and safety of Pulsed Radiofrequency treatment in chronic pain syndromes? • Aim: • To systematically review the evidence about efficacy and safety of pulsed radiofrequency in patients with chronic pain syndromes. Introdução à Medicina II | Teacher Luís Azevedo | Class 14

1.Introduction Whatispain? 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." PAIN “Chronic pain has been increasing in prevalence. It is considered the most underestimated health care problem impacting quality of life. A number of epidemiological studies conducted in different parts of the world, reported prevalence rates of chronic pain ranging from 12-80%. Chronic pain has detrimental effects on physical and mental health, daily activities, family relationships, employment and economic well-being of the sufferers and family caregivers. Since the epidemiological studies about chronic pain in Lebanon are limited, the aim of this article is to help understand the magnitude of the problem and to depict strategies for the prevention and management of chronic pain.” [1] Chronic Acute Introdução à Medicina II | Teacher Luís Azevedo | Class 14 [1] 1. Huijer H, Abu-saad. Chronic pain: a review. J Med Liban; 2010

1.Introduction Relievespainandimprovesmovementandfunction Helpsreduce stress levels Alterspainsignals as theytravel to thebrain Introdução à Medicina II | Teacher Luís Azevedo | Class 14 [2] Van Zundert J, Huntoon M, Patijn J, Lataster A, Mekhail N, van Kleef M. Cervical Radicular Pain. Pain Pract; 2009 Oct.

1.Introduction • A development of heat based radiofrequency denervation[3] • To treat especially chronic pain • Minimallyinvasivetargetselectivetechnique • Uses brief pulses ofhighvoltage (Rf range – 300kHz) to producecontrolledtissuedestruction • Heatdissipatesbetween pulses, avoidingthermocoagulation • Reducespainbymodullatingpaintransmission • Producestransientinibitionofevokedsynapticactivity[4] Radiofrequencytreatment [3] Pevzner E, David R, Leitner Y, Pekarsky I, Folman Y, Gepstein R. Pulsed radiofrequency treatment of severe radicular pain. Harefuah; 2005 Mar. [4] Byrd D, Mackey S. Pulsed radiofrequency for chronic pain. Curr Pain Headache Rep; 2008 Jan. Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods Project Development Phases • Research question formulation • Definition of selection criteria (inclusion and exclusion) • Definition and implementation of literature search methods and resources • Study selection using defined selection criteria • Data extraction from included studies • Critical appraisal and quality assessment of included studies • Data analysis and synthesis from included primary studies • Writing and disseminating final report Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods • Type of study Systematic Review • Units of analysis Articles • Data Search PubMed ISI Web of Knowledge Scopus Central Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods • Key-words Pain Chronic Pulsed Radiofrequency • Query PubMed: pulsed[All Fields] AND radiofrequency[All Fields] AND (("pain"[MeSH Terms] OR "pain"[All Fields]) AND chronic[All Fields]) Scopus: TITLE-ABS-KEY(radiofrequency) AND TITLE-ABS-KEY(pulsed) AND TITLE-ABS-KEY(pain) AND TITLE-ABS-KEY(chronic) ISI TS=(Radiofrequency SAME pulsed) AND TS=pain AND TS=chronic Central #1 MeSH descriptor Pain explode all trees #2 (Chronic): ti, ab, kw #3 (Radiofrequency Near Pulsed): ti, ab, kw • MeSHTerm: • Pain Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods • Research Limits Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods 13 notexcluded 65 excluded Introdução à Medicina II | Teacher Luís Azevedo | Class 14

2. Methods 4 8 20 0 Introdução à Medicina II | Teacher Luís Azevedo | Class 14

3. Results ArticlesExcluded Introdução à Medicina II | Teacher Luís Azevedo | Class 14

3. Results Publicationyear Introdução à Medicina II | Teacher Luís Azevedo | Class 14

3. Results 4 times was necessary a 3rd reviewer 74 times wasn’t necessary Introdução à Medicina II | Teacher Luís Azevedo | Class 14

3. Results ArticlesandJournals "Pain practice: the official journal of Word Institute of pain" - 13 articles "Pain Physician" - 9 articles "Pain medicine (Malden, Mass.)" - 7 articles Introdução à Medicina II | Teacher Luís Azevedo | Class 14

3. ResultsNon-excludedarticles:

4. Planning and development of future tasks Introdução à Medicina II | Teacher Luís Azevedo | Class 14

4. Planning and development of future tasks • Analysisoftheselectedarticles • Secondselectionstage • Data extraction • Qualityassessment (consort– clinicaltrials; strobe – observationalstudies, equatornetwork) • ReviewArticle’swriting • Abstract • Introduction • Methods • Results • Discussion Introdução à Medicina II | Teacher Luís Azevedo | Class 14

5. References • 1. Huijer H, Abu-saad. Chronic pain: a review. J Med Liban; 2010 • 2. Van Zundert J, Huntoon M, Patijn J, Lataster A, Mekhail N, van Kleef M. Cervical Radicular Pain. Pain Pract;2009 Oct. • 3. Pevzner E, David R, Leitner Y, Pekarsky I, Folman Y, Gepstein R. Pulsed radiofrequency treatment of severe radicular pain. Harefuah; 2005 Mar. • 4. ByrdD, Mackey S. Pulsed radiofrequency for chronic pain. Curr Pain Headache Rep; 2008 Jan. • 5. Malik K, Ben Zon T. Pulsed radiofrequency: a critical review of its efficacy. AnaesthIntensiveCare; 2007 Introdução à Medicina II | Teacher Luís Azevedo | Class 14

EFFICACY AND SAFETY OF Pulsed radiofrequency treatment in CHRONIC pain syndromes