Sekiguchi Shunya, Ishida Yusuke, Fujita Yosuke, Tomino Mikiko, Ohseto Kiyoshige
Department of Anesthesiology Tokyo Medical University Tokyo Japan.
Clin Case Rep. 2023 Jul 10;11(7):e7672. doi: 10.1002/ccr3.7672. eCollection 2023 Jul.
Phantom limb pain and stump pain are often intractable, and their incidences are relatively high. We report a case of a patient with phantom limb and stump pain of the finger, who was successfully treated by peripheral nerve blocks. The patient was a male truck driver in his fifties, who had his left annular finger amputated in an accident 2 years previously. Owing to poor pain control at the stump of his finger, he was referred to our department. The initial examination revealed pain about numerical rating scale (NRS) 6/10 in the left annular finger transection as well as allodynia. Although some pain relief had been observed with postoperative medication, he still had persistent resting pain of about NRS 4/10. Therefore, blocks of the ulnar nerve and median nerve were performed. After the blocks were performed, the pain improved to NRS 1 to 2/10, and pain upon movement also almost disappeared. Peripheral nerve blocks can be a useful treatment modality for phantom limb pain and stump pain in the fingers, as in this case.
幻肢痛和残端痛往往难以治疗,且发病率相对较高。我们报告一例手指幻肢痛和残端痛患者,通过外周神经阻滞成功治愈。患者为一名五十多岁的男性卡车司机,两年前在一次事故中左手环指被截肢。由于手指残端疼痛控制不佳,他被转诊至我科。初始检查发现,左环指断端疼痛数字评分量表(NRS)约为6/10,且存在痛觉过敏。尽管术后用药后疼痛有所缓解,但他仍有持续的静息痛,NRS约为4/10。因此,对尺神经和正中神经进行了阻滞。阻滞后,疼痛改善至NRS 1至2/10,活动时的疼痛也几乎消失。如本病例所示,外周神经阻滞可能是治疗手指幻肢痛和残端痛的一种有效治疗方式。