Overview
this study aims to assess the role of pulsed radiofrequency of the brachial plexus or pulsed radiofrequency of shoulder individual nerves in the management of post-mastectomy shoulder pain.
Description
Breast cancer is the second most common cancer world-wide following lung cancer. It afflicts about 1.7 million patients annually, of which 60% mandate surgery of the breast and/or the axilla, and nearly 20-50% of them may develop post-mastectomy pain syndrome.
Regarding pulsed RF of the brachial plexus, it is not tried up till now for shoulder pain. Since C 5,6,7 are derived from upper and middle trunks of brachial plexus, then innervation of shoulder joint can be blocked by interscalene brachial plexus block or pulsed radiofrequency . Review of literature demonstrated efficacy of PRF of brachial plexus in case studies for other conditions e.g. pain associated with a tumor involving the brachial plexus , refractory stump pain , chemotherapy-induced peripheral neuropathy of the upper limb and radiation-induced brachial plexopathy .
Eligibility
Inclusion Criteria:
- Age (18-65) Years.
- American Society of Anesthesiologists (ASA) physical status (II- III).
- Patients with post mastectomy shoulder pain.
- Body mass index (BMI): (20-40) kg/m2.
- Patients on maximum daily dose tramadol ( 450mg ) and still in pain
Exclusion Criteria:
- Patient refusal.
- Known sensitivity or contraindication to drugs used in the study.
- Pregnancy.
- Recent myocardial infarction.
- Hemodynamically unstable.
- Local and systemic sepsis.
- Psychiatric illness.