O'Connor Lizabeth A, Houseman Bryan, Taffe Daniel, Quinn Curtis C
Elliot Health System, Division of Thoracic Surgery, 1 Elliot Way, Manchester, NH 03103, United States.
Elliot Health System, Division of Orthopedic Trauma, 1 Elliot Way, Manchester, NH 03103, United States.
Trauma Case Rep. 2022 Jul 13;41:100678. doi: 10.1016/j.tcr.2022.100678. eCollection 2022 Oct.
Amputation of an extremity frequently results in significant phantom limb pain. The etiology of which is not well understood. Central and peripheral factors appear to play a role. Pain relief interventions often are attempted several weeks to months later. Peripheral nerve injury can rapidly result in cortical somatosensory changes potentially making early intervention important in preventing any permanent changes in nerve pathways.
We present a case of traumatic forequarter (interscapulothoracic) amputation treated with cryoanalgesia of the brachial plexus for pain control <72 h after injury. The patient denied painful phantom limb pain and postoperative pain at the surgical site immediately following surgery and over a six month follow up period.
Cryoanalgesia facilitates extended duration of pain control of the affected peripheral nerve which may be of particular benefit in patients sustaining either surgical or traumatic amputations, particularly when applied early to prevent the transmission of noxious signals to the central nervous system.
肢体截肢常常导致严重的幻肢痛。其病因尚未完全明确。中枢和外周因素似乎都发挥着作用。疼痛缓解干预措施通常在数周或数月后才尝试实施。外周神经损伤可迅速导致皮质体感变化，这可能使早期干预对于预防神经通路的任何永久性改变至关重要。
我们报告一例创伤性前半侧肢体（肩胛胸壁间）截肢病例，在受伤后<72小时采用臂丛神经冷冻镇痛法控制疼痛。术后即刻及六个月的随访期间，患者均否认有疼痛性幻肢痛及手术部位的术后疼痛。
冷冻镇痛有助于延长对受影响外周神经的疼痛控制时间，这对于接受手术或创伤性截肢的患者可能特别有益，尤其是在早期应用以防止有害信号向中枢神经系统传递时。
