Thapa D, Ahuja V, Verma P, Das C
Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
Saudi J Anaesth. 2016 Jan-Mar;10(1):107-9. doi: 10.4103/1658-354X.169488.
Chronic postsurgical pain (CPSP) is a distressful condition following hernia surgery. A 25-year-old, 55 kg male patient presented with severe pain on the right side of the lower abdomen that radiated to the testicle and the inner side of the thigh. Patient was symptomatic since 5 months following inguinal herniorrhaphy surgery. The pain was not relieved with pharmacological and interventional nerve blocks. An ultrasound-guided ilioinguinal-iliohypogastric (II-IH) block with extended duration (42°C, four cycles of 120 s each) pulsed radiofrequency (PRF) and a diagnostic genital branch of genitofemoral nerve (GGFN) block provided pain relief. After 1-month, an extended duration PRF in GGFN resulted in complete resolution of symptoms. During a regular follow-up of 9 months, patient reported an improved quality-of-life. We believe the successful management of CPSP following hernia repair with single extended duration PRF of II-IH and GGFN has not been described in the literature.
慢性术后疼痛(CPSP)是疝气手术后令人痛苦的一种状况。一名25岁、体重55千克的男性患者出现右下腹严重疼痛,并放射至睾丸和大腿内侧。该患者自腹股沟疝修补手术后5个月一直有症状。疼痛通过药物治疗和介入性神经阻滞均未缓解。超声引导下的延长持续时间(42°C,每个120秒共四个周期)的脉冲射频(PRF)髂腹股沟 - 髂腹下神经(II - IH)阻滞以及诊断性股生殖神经生殖支(GGFN)阻滞缓解了疼痛。1个月后,对GGFN进行延长持续时间的PRF治疗使症状完全消除。在9个月的定期随访中,患者报告生活质量有所改善。我们认为,文献中尚未描述过采用单次延长持续时间的II - IH和GGFN的PRF成功治疗疝气修补术后的CPSP。