Radiofrequency termocoagulation for the treatment of lower extremity ischemic pain: Comparison of monopolar and bipolar modes

Abstract

Objective: Radiofrequency thermocoagulation (RFT) has been reported to be used safely for the treatment of ischemic lower extremity pain. The object of the present study was to evaluate the efficiency of RFT for the treatment of lower extremity ischemic pain and compare the effectivity of monopolar RFT and bipolar RFT mode.
Material and Methods: Following Ethic committee approval, 30 ASA I-III patients with ischemic lower extremity pain, between 18 and 65 years aged were recruited. Patients were randomly allocated into two groups to receive monopolar radiofrequency thermocoagulation (80°C) for 2 minutes from L2-3 level in group MRT (n = 15) or bipolar radiofrequency thermocoagulation (80°C) for 2 minutes from L2-3 level in group BRT (n=15). Systolic and diastolic blood pressures, heart rate, pain scores and supplement analgesic requirements were recorded at 24 hour, and 7, 30 and 90 days after discharge.
Results: NRS values in both group significantly decreased over time and it was found significantly lower in group BRT than in group MRT only after the first and third months (p<0.05). However, supplement analgesic requirements were similar and there was no significant difference between the two groups at any study period (p>0.05). No adverse event or complication regarding the procedure or treatment was reported.
Conclusion: In patients with ischemic lower extremity pain, both monopolar and bipolar radiofrequency thermocoagulation treatment modalities were found to decrease significantly pain levels. However, bipolar mod led to lower pain scores at the 30 and 90 days and longer duration of analgesia than monopolar mode.