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病例报告:冷冻镇痛法治疗胸壁肿瘤所致顽固性胸痛

Case Report: Cryoanalgesia for intractable thoracic pain due to chest wall tumor.

作者信息

Paim Thays Sellan, Guernelli Myrna, Simoneti Rafael Soares, Miotto André

机构信息

Department of Thoracic Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Front Oncol. 2025 Aug 6;15:1516805. doi: 10.3389/fonc.2025.1516805. eCollection 2025.

Abstract

INTRODUCTION

Postoperative pain in thoracic surgery is a major concern, often delaying recovery. Cryoanalgesia, using pressurized nitrous oxide, offers long-term pain relief by temporarily blocking peripheral nerve function. It takes effect within 72 hours, so an intercostal nerve block is used for immediate pain relief. Cryoanalgesia is effective for severe pain, with minimal side effects and no drug interactions.

CASE REPORT

A 63-year-old man with severe thoracic pain, unresponsive to opioids, was diagnosed with a typical carcinoid tumor after a CT scan revealed lesions in his lung, thoracic wall, and adrenal gland. He underwent surgery for the thoracic lesions with cryoanalgesia, leading to excellent recovery and no pain. A month later, the adrenal lesion was removed laparoscopically. He remains pain-free and free of recurrence after one year, indicating successful treatment.

CONCLUSION

Cryoanalgesia provides long-term relief for chest pain caused by tumors, with minimal side effects. It improves recovery and should be considered an essential part of pain management in thoracic surgery.

摘要

引言

胸外科手术后的疼痛是一个主要问题,常常会延迟恢复。使用加压一氧化二氮的冷冻镇痛法通过暂时阻断外周神经功能来提供长期的疼痛缓解。它在72小时内起效,因此肋间神经阻滞用于立即缓解疼痛。冷冻镇痛法对重度疼痛有效,副作用极小且无药物相互作用。

病例报告

一名63岁男性,患有严重胸痛,对阿片类药物无反应,在CT扫描显示其肺部、胸壁和肾上腺有病变后,被诊断为典型类癌肿瘤。他接受了针对胸部病变的手术并采用冷冻镇痛法,恢复良好且无疼痛。一个月后,通过腹腔镜切除了肾上腺病变。一年后,他仍无疼痛且无复发迹象,表明治疗成功。

结论

冷冻镇痛法能为肿瘤引起的胸痛提供长期缓解,副作用极小。它能改善恢复情况,应被视为胸外科疼痛管理的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a009/12366094/a0ba346ef6c5/fonc-15-1516805-g001.jpg

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