Super-voltage Pulsed Radiofrequency of Stellate Ganglion Versus Super-voltage Pulsed Radiofrequency of T2 T3 Sympathetic Ganglia in Managing Postmastectomy Pain Syndrome.

Rationale for our study:

Supervoltage Pulsed Radiofrequency (SV-PRF) is an advanced neuromodulation technique that delivers higher-voltage short pulses (typically 60-90 V) while keeping tissue temperature below neurodestructive levels (<42°C), allowing deeper electric-field penetration, enhanced C-fiber modulation, and sustained changes in sympathetic outflow without causing structural nerve injury, theoretically providing longer-lasting analgesia and improved safety compared to standard PRF. Among interventional options for sympathetically mediated PMPS, stellate ganglion (SGB) and T2-T3 sympathetic interventions have emerged as promising therapies, yet they differ in mechanism, outcomes, and clinical implications. The current literature lacks direct head-to-head comparisons of these two techniques regarding efficacy, long-term relief, and safety, as most studies evaluate each intervention individually. This knowledge gap, combined with the limited efficacy of conventional pharmacologic treatments, highlights the need for a comparative study to determine which approach offers superior pain relief, durability, safety, and cost-effectiveness. By examining short- and long-term outcomes, as well as resource utilization, this study aims to provide evidence-based guidance to optimize clinical decision-making, help clinicians select the most appropriate intervention for PMPS patients, and establish practical, sustainable treatment strategies. .(33, 34)

Aim of the study:

The aim of this study is to compare the effectiveness of supervoltage pulsed radifrequency of stellate ganglion and supervoltage pulsed radifrequency of T2-T3 sympathetic ganglia in the treatment of postmastectomy pain syndrome.

Primary Objectives: