Application of Nalbuphine in Trigeminal Ganglion Pulse Radiofrequency Surgery in Patients with Postherpetic Neuralgia

This study aimed to explore the application value of nalbuphine in pulsed radiofrequency operation of trigeminal ganglion in patients with postherpetic neuralgia (PHN). Thirty patients with PHN were randomly divided into the nalbuphine (Nalbu) group and ketorolac tromethamine (KT) group and received CT-guided pulsed radiofrequency surgery on trigeminal ganglion. The numeric rating scale (NRS) scores of patients were recorded at preoperative, intraoperative, and postoperative time points, before going to bed, and the next morning after the operation. In addition, the number of breakthrough pain before operation and within 24 hours after operation, the incidence of nausea and vomiting within 24 hours after surgery, and the patient’s sleep quality before and on the day after surgery were evaluated. The outcome data demonstrated that patients treated with nalbuphine had lower NRS scores after the pulse radiofrequency operation during and after the pulse radiofrequency operation compared to those with KT. In addition, nalbuphine effectively decreased the number of breakthrough pain, reduced the occurrence of nausea and vomiting after surgery, and improved the sleep quality. In conclusion, intramuscular injection of nalbuphine 30 min before trigeminal ganglion pulse radiofrequency surgery can be conducive to pain relief and improve the postoperative comfort of patients, providing an effective alternative for the alleviation of PHN in clinic.

MinimallyInvasive Radiofrequency Surgery in Sleep-Disordered Breathing

Sleep-disordered breathing encompasses a spectrum of conditions ranging from simple snoring to obstructive sleep apnoea (OSA). Radiofrequency surgery represents a relatively new technique available to surgeons involved in managing this condition. Its principal advantage relates to its minimally invasive nature resulting in a reduced morbidity when compared to traditional sleep surgery. The presence of good-quality research evaluating the long-term outcomes is currently scarce, although the short-term data is promising. Careful patient selection appears to be paramount in obtaining a sustained improvement. The role of radiofrequency surgery in sleep-disordered breathing has been reviewed.

Effect of radiofrequency vs other surgeries in the management of obstructive sleep apnoea

<p class="abstract"><strong>Background:</strong> Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA.</p><p class="abstract"><strong>Methods:</strong> In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided. </p><p class="abstract"><strong>Results:</strong> There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc.</p><p class="abstract"><strong>Conclusions:</strong> Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.</p>

The Perioperative Utilization of Sleep Monitoring Applications on Smart Phones in Habitual Snorers With Isolated Inferior Turbinate Hypertrophy

The aim of this study is to investigate the novel use of sleep monitoring applications in simple snorers undergoing concha radiofrequency surgery and to compare and correlate the pre- and postoperative symptoms of these patients using the Nasal Obstruction Symptom Evaluation (NOSE) scale. In this retrospective analysis, we have selected 18 consecutive patients with no comorbid sleep or medical disorders suffering from chronic nasal blockage and habitual snoring due to isolated submucous inferior turbinate hyperplasia. After a median follow-up of 8.3 months, the NOSE scale and snoring sound intensity levels monitored by the smart phone application showed statistically significant improvements after the surgical procedure ( P < .05), and we also detected a positive correlation between the levels of snoring percentage and the total NOSE scores ( P < .05). We hypothesize that sleep monitoring applications could be easily used as portable monitors for basic home sleep studies in conjunction with a comprehensive sleep evaluation. Alternatively, such applications may simply be used for objective monitoring of the postoperative success of surgical interventions in the upper respiratory tract region such as concha reduction surgeries as presented herein.

Megújulás az alsó végtagi varicositas műtéti kezelésében

During the 20th century, continuous development of classic varicose vein surgery was carried out. From the beginning of the 21st century, however, new endovascular interventions were introduced. Compared to classic surgery, their main benefit is that no incision and dissection is necessary. Only catheters are used to scar the saphenous stems, which are introduced via punctures. Before and during the intervention, ultrasound is used. Laser surgery is the most popular option, and its outcomes have improved a lot with the introduction of laser crossectomy. Radiofrequency surgery is another intervention which is widely performed. A further heat ablation method is the steam operation. One newer technique is the cyanoacrylate tissue adhesive operation. The well-known practice of sclerotherapy has developed by turning the liquid sclerosant into foam, and by causing mechanical damage to the intimal layer of the vein. The new methods have fewer complications because these avoid incisions and dissections during the interventions. Orv Hetil. 2018; 159(52): 2195–2201.