Hong Myong-Joo, Kim Yeon-Dong, Park Jeong-Ki, Hong Hyon-Joo
Department of Rheumatology, Presbyterian Medical Center, Jeonju, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, School of Medicine, 344-2, Sinyong-dong, Iksan, 570-711, Republic of Korea.
J Anesth. 2016 Apr;30(2):356-9. doi: 10.1007/s00540-015-2121-x. Epub 2015 Dec 23.
Pudendal neuralgia is characterized by chronic pain or discomfort in the area innervated by the pudendal nerve, with no obvious cause. A successful pudendal nerve block is crucial for the diagnosis of pudendal neuralgia. Blind or fluoroscopy-guided pudendal nerve blocks have been conventionally used for diagnosis and treatment; however, ultrasound-guided pudendal nerve blocks were also reported recently. With regard to the achievement of long-term effects, although pulsed radiofrequency performed under fluoroscopic guidance has been reported, that performed under ultrasound guidance is not well reported. This report describes two cases of pudendal neuralgia that were successfully managed using ultrasound-guided pulsed radiofrequency and presents a literature review of pudendal nerve block techniques. However, in the management of chronic neuropathic pain, physicians should keep in mind that the placebo effect related to invasive approaches must not be neglected.
阴部神经痛的特征是阴部神经所支配区域出现慢性疼痛或不适，且无明显病因。成功的阴部神经阻滞对于阴部神经痛的诊断至关重要。传统上，盲法或荧光镜引导下的阴部神经阻滞一直用于诊断和治疗；然而，最近也有关于超声引导下阴部神经阻滞的报道。关于实现长期效果，尽管已有报道在荧光镜引导下进行脉冲射频治疗，但在超声引导下进行的相关报道较少。本报告描述了两例通过超声引导下脉冲射频成功治疗的阴部神经痛病例，并对阴部神经阻滞技术进行了文献综述。然而，在慢性神经病理性疼痛的治疗中，医生应牢记与侵入性治疗方法相关的安慰剂效应不容忽视。
