Vinagre J M, Doody K, Harmon D
Department of Anaesthesia, Pain Medicine and Intensive Care Beaumont Hospital Dublin Ireland.
Department of Anaesthesia, Pain Medicine and Intensive Care Cork University Hospital Cork Ireland.
Anaesth Rep. 2019 Mar 11;7(1):14-17. doi: 10.1002/anr3.12000. eCollection 2019 Jan-Jun.
We describe the treatment of chemotherapy-induced peripheral neuropathy in the upper limb of a patient via ultrasound-guided pulsed radiofrequency of the brachial plexus. A 54-year-old female, who underwent chemotherapy and mastectomy for left-sided breast cancer, presented to the pain clinic describing continuous and severe shock-like pain in the posterolateral aspect of the left upper limb, above the elbow. A diagnosis of chemotherapy-induced peripheral neuropathy was made. Pain management with multi-modal analgesia was not fully effective and pulsed radiofrequency was offered as an alternative. Ultrasonography of the supraclavicular region was used to identify the brachial plexus, followed by pulsed radiofrequency using an insulated-tip needle that produced paraesthesia in the affected area. Onset of pain relief occurred one week post-procedure and lasted approximately 10 weeks. An estimated 80% decrease in pain intensity was reported by the patient. We propose that pulsed radiofrequency can be offered as a pain management alternative in certain presentations of chemotherapy-induced peripheral neuropathy.
我们描述了通过超声引导下对臂丛神经进行脉冲射频治疗一名患者化疗引起的上肢周围神经病变的情况。一名54岁女性，因左侧乳腺癌接受了化疗和乳房切除术，前来疼痛门诊就诊，描述左上肢肘部以上后外侧持续且严重的电击样疼痛。诊断为化疗引起的周围神经病变。多模式镇痛的疼痛管理未完全有效，于是提供脉冲射频作为替代方案。使用锁骨上区域超声来识别臂丛神经，随后使用绝缘尖端针进行脉冲射频，该操作在受影响区域产生了感觉异常。术后一周开始疼痛缓解，持续约10周。据患者报告，疼痛强度估计降低了80%。我们建议，在化疗引起的周围神经病变的某些表现中，脉冲射频可作为一种疼痛管理的替代方案。
