Efficacy and safety of sympathetic radiofrequency thermocoagulation in the treatment of cold hypersensitivity

Abstract

BackgroundCold hypersensitivity (CH) is a sensation of cold in the limbs and (or) body of a patient in an environment that is not considered cold by unaffected people, or a strong feeling of cold at a relatively low temperature. However, the currently available treatments are limited and often unsatisfactory. This study aimed to evaluate the clinical efficacy and safety of the sympathetic radiofrequency thermocoagulation (RF-TC) technique in patients with CH disorder.MethodsThe study is a retrospective analysis. A total of 71 were entered into the final analysis and all patients underwent computed tomography-guided thoracic (lumbar) sympathetic nerve RF-TC on an elective basis. The values of terminal temperature (T) and perfusion index (PI) of patients before and after treatment were recorded. Patients were followed up clinically at regular intervals and their Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) scores were recorded to detect postoperative complications and assess patient satisfaction with the treatment.ResultsAll patients completed the radiofrequency treatment. Compared with the preoperative period, VAS and PSQI scores were significantly lower at all postoperative time periods (P < 0.001). Patients had significantly higher postoperative terminal temperatures and perfusion indices on the right and left sides than before surgery (P < 0.001). The overall patient satisfaction score was 4 (3–5) at 3 years of postoperative follow-up. There were 20 recurrences (28.2%). The main postoperative complications were postoperative local pain and compensatory hyperhidrosis. No other adverse events or deaths were observed.ConclusionRF-TC for CH could be a feasible, effective, and safe treatment option to improve patients' symptoms of cold sensation. Yet, more researches are needed to verify this potentially efficient and standardized treatment.

Advances in the Treatment of Neuropathic Pain by Sympathetic Regulation

“…The patient was returned to the ward when vital signs were stable. Studies have shown [57][58][59] that CT-guided lower back sympathetic RF thermocoagulation has been gradually applied to the treatment of many autonomic nerve diseases, such as plantar hyperhidrosis (PH), cold hypersensitivity (CH), and diabetic peripheral neuropathy (DPN). Another study reported [60,61] that lumbar sympathetic radiofrequency thermocoagulation achieved a lasting effect in the treatment of CRPS, with a pain relief rate of 91.7% at three months and 83.3% at six months after treatment.…”