手术失败后不可控的左手腕疼痛与周围神经刺激的成功疼痛管理:1例报告。

Pain medicine case reports Pub Date : 2024-11-01
Robert Moghim, Mahmoud Morsi, Alaa Abd-Elsayed
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引用次数: 0

摘要

背景:左侧桡浅神经的复杂区域疼痛综合征(CRPS)是疼痛管理的重大挑战,特别是当保守治疗和多次手术不能提供缓解时。病例报告:本病例研究检查了一名50岁的患者,患有左桡浅神经CRPS II型病史,自2021年以来接受了15次干预,包括6次不成功的手术,并在工伤后经历了极度无法控制的疼痛。在2022年11月永久植入周围神经刺激器(PNS)后,患者在过去一年半的时间里疼痛得到了显著缓解,没有出现并发症的迹象,也没有必要进一步干预。在工作补偿规则允许的情况下,PNS试验采用单切口技术,使用8字形2.0丝缝线配置将导联固定在肱桡肌筋膜上。结论:PNS已成为手术失败后慢性疼痛的一种有价值的治疗方式。本病例研究证明了PNS在为左侧桡浅神经CRPS患者提供持续疼痛缓解方面的有效性。PNS治疗难治性疼痛的长期疗效和安全性有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful Pain Management of Uncontrollable Left Wrist Pain With Peripheral Nerve Stimulation Following Failed Surgeries: A Case Report.

Background: Complex regional pain syndrome (CRPS) of the left superficial radial nerve can present significant challenges in pain management, especially when conservative therapies and multiple surgeries fail to provide relief.

Case report: This case study examines a 50-year-old patient with a history of CRPS type II of the left superficial radial nerve, who underwent 15 interventions, including 6 unsuccessful surgeries since 2021, and experienced extreme, uncontrolled pain after a work-related injury. After the permanent implantation of peripheral nerve stimulator (PNS) in November 2022, the patient enjoyed remarkable pain relief for the past one and a half years, with no signs of complications or necessity for further interventions. The PNS trial, permitted by work compensation rules, utilized a single incision technique, anchoring the leads to the brachioradialis fascia using a figure-of-eight 2.0 silk suture configuration.

Conclusions: PNS has emerged as a valuable treatment modality for chronic pain following failed surgeries. This case study demonstrates the effectiveness of PNS in providing sustained pain relief for a patient with CRPS of the left superficial radial nerve. Further research is warranted to explore the long-term efficacy and safety of PNS in managing refractory pain conditions.

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