The Efficiency Of Ganglion Impar Radiofrequency Thermocoagulation For Perineal Pain

Objective:To estimate the effectiveness and safety of ganglion impar radiofrequency thermocoagulation in the treatment of perineal pain,which was administrated by observing and comparing the changes of patients' Numerical Rating Scale(NRS)and quality of life(QL-Index scale)during the treatment of perineal pain with ganglion impar block and radiofrequency thermocoagulation,and recording the complications and adverse reactions during the treatment.Methods:40 patients with perineal pain admitted to the pain department of our hospital from October 2016 to October 2018 were randomly divided into block group and radio frequency group.The block group was treated with lidocaine injection to block ganglion impar,while the radio frequency group was treated with radiofrequency thermocoagulation of ganglion impar.Both groups were evaluated with Numerical Rating Scale score and quality of life score.Meanwhile,complications and adverse reactions occurred during the treatment were recorded.After that,it was analyzed by statistical software,and the difference was statistically significant according to the test level P<0.05.Results:1.Compared with baseline data such as gender,age,duration of disease,NRS and quality of life index before treatment,there was no statistical significance between the two groups((P>0.05).2.Degree of pain assessment:The NRS of the two groups at 24 hours after treatment,7 days after treatment,1 month after treatment and 3 months after treatment were significantly lower than those before treatment(P<0.01).There was no significant difference in NRS between the two groups 24 hours after treatment(P>0.05).There was significant difference in NRS between the two groups on the 7th day and the 1st month after treatment(P<0.05).There was significant difference in NRS between the two groups 3 months after treatment(P<0.01).3.Therapeutic effect:The significant effective rate of the radio frequency group was 95.0%at 24 hours after treatment,and that of the block group was 90.0%at 24 hours after treatment.There was no significant difference between the two groups(?2 ?0.360,P= 0.548);The significant effective rate of the radio frequency group was 85.0%on the 7th day after treatment,and that of the block group was 80.0%on the 7th day after treatment.There was no significant difference between the two(X6=0.173,P=0.677);The significant effective rate of the radio frequency group was 85.0%one month after treatment,and that of the block group was 60.0%one month after treatment.There was no significant difference between the two groups(?2 =1.905,P= 0.168);The effective remission rate was 70.0%in the radio frequency group and 35.0%in the block group after 3 months of treatment.The comparison between the two was statistically significant(?2 = 4.912,P=0.027).4.Quality of life evaluation:The QL-Index score of the two groups before treatment had no statistical significance(?>0.05);The QL-Index scores of the two groups at 1 month after treatment and 3 months after treatment were significantly lower than those before treatment(P<0.01).There was significant difference in QL-Index scores between the two groups 1 month after treatment and 3 months after treatment(P<0.01).5.All of patients will suffer temporary pain aggravation after the puncture needle reaches the target position or when undergoing radiofrequency thermocoagulation,which is tolerable.There were no complications such as rectal perforation,infection,fistula formation,postoperative pain aggravation,change of stool and urine function and dyskinesia in the two groups.Conclusion:Impar ganglion block and ganglion radiofrequency thermocoagulation can effectively relieve perineal pain.The therapeutic effect of radiofrequency thermocoagulation is better than that of nerve block therapy and lasts longer.