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Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain

A median nerve injury in the forearm may lead to devastating sequelae if left untreated. Even with appropriate treatments involving microsurgical techniques and postoperative care, patients may still experience lasting neuropathic pain that significantly reduces their quality of life. Pulsed radiofr...

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Autores principales: Park, Yoo Jung, Lee, Man Hee, Kwon, So Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726776/
https://www.ncbi.nlm.nih.gov/pubmed/31342812
http://dx.doi.org/10.1177/0300060519863533
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author Park, Yoo Jung
Lee, Man Hee
Kwon, So Young
author_facet Park, Yoo Jung
Lee, Man Hee
Kwon, So Young
author_sort Park, Yoo Jung
collection PubMed
description A median nerve injury in the forearm may lead to devastating sequelae if left untreated. Even with appropriate treatments involving microsurgical techniques and postoperative care, patients may still experience lasting neuropathic pain that significantly reduces their quality of life. Pulsed radiofrequency (PRF) is widely performed to alleviate such neuropathic pain caused by trauma. A 47-year-old man visited our pain clinic with allodynia, hyperalgesia, paresthesia, skin color changes, and atrophy in the right forearm. In the orthopedic department, the patient was treated by neurectomy of the median nerve to manage the intractable pain. However, the effect was unsatisfactory. The fourth median nerve block performed in our pain clinic after neurectomy produced good results, and ultrasound-guided PRF of the median nerve was performed. The patient showed 80% relief of symptoms within 5 hours after the procedure. The visual analog scale score for the forearm decreased from 8/10 to 1/10. This case suggests that ultrasound-guided PRF can be a therapeutic option for the management of refractory neuropathic pain after neurectomy in patients with a median nerve injury.
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spelling pubmed-67267762019-09-13 Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain Park, Yoo Jung Lee, Man Hee Kwon, So Young J Int Med Res Case Report and Case Series A median nerve injury in the forearm may lead to devastating sequelae if left untreated. Even with appropriate treatments involving microsurgical techniques and postoperative care, patients may still experience lasting neuropathic pain that significantly reduces their quality of life. Pulsed radiofrequency (PRF) is widely performed to alleviate such neuropathic pain caused by trauma. A 47-year-old man visited our pain clinic with allodynia, hyperalgesia, paresthesia, skin color changes, and atrophy in the right forearm. In the orthopedic department, the patient was treated by neurectomy of the median nerve to manage the intractable pain. However, the effect was unsatisfactory. The fourth median nerve block performed in our pain clinic after neurectomy produced good results, and ultrasound-guided PRF of the median nerve was performed. The patient showed 80% relief of symptoms within 5 hours after the procedure. The visual analog scale score for the forearm decreased from 8/10 to 1/10. This case suggests that ultrasound-guided PRF can be a therapeutic option for the management of refractory neuropathic pain after neurectomy in patients with a median nerve injury. SAGE Publications 2019-07-25 2019-08 /pmc/articles/PMC6726776/ /pubmed/31342812 http://dx.doi.org/10.1177/0300060519863533 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report and Case Series
Park, Yoo Jung
Lee, Man Hee
Kwon, So Young
Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title_full Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title_fullStr Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title_full_unstemmed Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title_short Pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
title_sort pulsed radiofrequency of the median nerve under ultrasound guidance for management of intractable neuropathic pain
topic Case Report and Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726776/
https://www.ncbi.nlm.nih.gov/pubmed/31342812
http://dx.doi.org/10.1177/0300060519863533
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