Kumar Ajit, Kantha Manasa, Goyal Sonal, Atter Pradeep
Department of Anesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
MGM Medical College, Kamothe, Mumbai, India.
Anesth Pain Med (Seoul). 2024 Oct;19(4):349-352. doi: 10.17085/apm.24035. Epub 2024 Oct 31.
Phantom limb pain (PLP) is the most common type of pain experienced by amputees and is chronic and complex, with manifestations including pain in a limb that no longer exists. To date, treatments that are pharmaceutical or surgical in nature are relatively ineffective at bringing much relief as the pathophysiology of PLP is somewhat obscure. Chronic pain syndromes such as PLP may benefit from sympathetic nervous system modulation through the stellate ganglion.
Ten refractory PLP patients treated with ultrasound-guided stellate ganglion pulsed radiofrequency ablation (SG PRF) after a diagnostic stellate ganglion block took effect: A case series Patients were assessed before and after the treatment at 1 week, 1 month, and 3 months. Significant reductions in pain as measured using a numerical rating scale; Pain Disability Indexwas improved, and Medication Quantification Scale also was improved. Minimal side effects.
Ultrasound-guided SG PRF has provided promising results for PLP by giving the patient with sustained pain relief and functional improvement without much side effects. Further studies need to be done to validate this finding.
幻肢痛(PLP)是截肢者最常经历的疼痛类型,具有慢性和复杂性,表现为不存在的肢体疼痛。迄今为止,由于PLP的病理生理学尚不清楚,药物或手术治疗在缓解疼痛方面相对无效。像PLP这样的慢性疼痛综合征可能受益于通过星状神经节对交感神经系统的调节。
10例难治性PLP患者在诊断性星状神经节阻滞生效后接受了超声引导下星状神经节脉冲射频消融术(SG PRF):一个病例系列。在治疗前以及治疗后1周、1个月和3个月对患者进行评估。使用数字评分量表测量的疼痛显著减轻;疼痛残疾指数得到改善,药物量化量表也得到改善。副作用极小。
超声引导下的SG PRF为PLP患者提供了有希望的结果,能使患者持续缓解疼痛并改善功能,且副作用不大。需要进一步研究来验证这一发现。