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1.
Kyobu Geka ; 73(2): 157-159, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32393727

RESUMO

A 18-year-old man was referred to our hospital complaining of chest abnormal shadow of the left upper lung field in mass screening chest X-ray. Although his left anterior chest wall swelled, he did not recognize that. Computed tomography and magnetic resonance imaging demonstrated a dumbbell shaped tumor of the left 1st intercostal space which had grown both inside and outside the thoracic cavity. As a possibility of solitary fibrous tumor or myxoma was not excluded, the patient underwent tumor resection. A solid tumor connected to the 1st intercostal nerve was easily dissected from surrounding tissue. Pathological examination revealed the tumor was consisted of spindle shaped cells without atypia, and diagnosed as neurilemmoma without malignancy. Based on anatomical pathway of intercostal nerves, we speculate that the tumor originated from anterior cutaneous nerve.


Assuntos
Neurilemoma , Parede Torácica , Adolescente , Humanos , Nervos Intercostais , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
2.
Ann Palliat Med ; 9(2): 447-450, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32268771

RESUMO

BACKGROUND: To investigate the effectiveness and rationality of different administration modes of dexmedetomidine with 0.5% ropivacaine on intercostal nerve block. METHODS: In total, 150 patients aged from 20-45 years with a body mass index (BMI): 18.5-23.9 kg/m2, met the criteria from the American Society of Anesthesiologists (ASA) class: I-II, and underwent lumpectomy in our center were equally randomized into three groups using a table of random numbers. Group D1: perineural administration of dexmedetomidine 0.5 µg/kg + intercostal nerve block with 0.5% ropivacaine; group D2: intravenous infusion of dexmedetomidine0.5 µg/kg + intercostal nerve block with 0.5% ropivacaine; and group R: intercostal nerve block with 0.5% ropivacaine. The Numerical Rating Scale (NRS) of pain and the Ramsay Sedation Scale were used for assessing pain and sedation levels 4, 8, 12, and 24 hours after the operation. The total duration of analgesia, total requirement of rescue analgesia, and adverse reactions were recorded. RESULTS: The NRS scores in groups D1 and D2 were significantly lower than that in group R, 8 hours after the operation (both P<0.05), and the NRS score in group D1 was significantly lower than in group D2 12 hours after the operation (P<0.05). The Ramsay scores showed no significant differences among all three groups at all time points after surgery. The duration of analgesia in group D1 was significantly longer than in group D2 (P<0.05). No rescue analgesia was needed in all three groups, and no adverse reactions such as dizziness, dry mouth, nausea, vomiting, and respiratory depression were reported. CONCLUSIONS: The combinations of dexmedetomidine with ropivacaine for intercostal nerve blocking can prolong the duration of analgesia after lumpectomy; however, the duration of analgesia is longer via the perineural route than via the intravenous route.


Assuntos
Analgesia/métodos , Anestésicos Locais/administração & dosagem , Dexmedetomidina/administração & dosagem , Bloqueio Nervoso/métodos , Dor Pós-Operatória/prevenção & controle , Ropivacaina/administração & dosagem , Adulto , Analgésicos não Entorpecentes/administração & dosagem , Feminino , Humanos , Nervos Intercostais/efeitos dos fármacos , Masculino , Estudos Prospectivos , Adulto Jovem
3.
World Neurosurg ; 138: 77-82, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32105875

RESUMO

BACKGROUND: Chronic abdominal pain is a debilitating condition known for its multifactorial nature. Outcomes with spinal cord stimulation (SCS) for abdominal pain syndromes are noticeably absent in the literature. To date, there have been no published reports of novel waveforms of SCS for management of chronic abdominal pain. We assessed the efficacy and durability of BurstDR SCS in reducing abdominal pain and analgesic consumption. CASE DESCRIPTION: We performed a retrospective review of medical records from 3 patients with different etiologies of abdominal pain (postherniorrhaphy pain syndrome, Crohn disease, abdominal neuropathy). All patients underwent thoracic laminectomy for BurstDR SCS paddle lead and pulse generator placement after a successful trial stimulation period. Data were collected with a telephone survey after a minimum duration of >24 months following implantation. Pain scores were measured using a numeric rating scale. Two of 3 patients were entirely pain-free and reported Patient Global Impression of Change scores of 7 after a minimum follow-up of >24 months. While the third patient continued to have chronic as well as episodic abdominal pain, he was able to discontinue all narcotic pain medications and experienced a 33% decrease in frequency and 60% decrease in severity of monthly pain exacerbations. He reported satisfaction and a Patient Global Impression of Change of 6. CONCLUSIONS: BurstDR SCS is a new programming modality, and long-term follow-up is necessary to determine its durability. Despite varying etiologies of abdominal pain, this series suggests BurstDR SCS sustained for >2 years might be effective as a treatment for abdominal pain syndromes. Future studies of SCS would benefit from standardized abdominal pain scores and high-powered studies using global patient registries.


Assuntos
Dor Abdominal/terapia , Estimulação da Medula Espinal/métodos , Doença Crônica , Doença de Crohn/complicações , Eletrodos Implantados , Feminino , Herniorrafia/efeitos adversos , Humanos , Nervos Intercostais/patologia , Laminectomia , Masculino , Pessoa de Meia-Idade , Entorpecentes/uso terapêutico , Medição da Dor , Dor Pós-Operatória/terapia , Satisfação do Paciente , Doenças do Sistema Nervoso Periférico/complicações , Resultado do Tratamento
4.
Ann Thorac Surg ; 109(1): 249-254, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521592

RESUMO

BACKGROUND: We reviewed the efficacy of intraoperative intercostal nerve cryoanalgesia for pain control in patients undergoing descending and thoracoabdominal aortic aneurysm repairs. METHODS: During 2013 and 2017, 241 patients underwent descending and thoracoabdominal aortic aneurysm repair. Of those, 38 patients were treated with intraoperative cryoanalgesia to the intercostal nerves at the level of 4th to 10th under electromyography guidance and were compared with patients who did not receive cryoanalgesia. Both groups received multilevel paravertebral block and local infiltration with liposomal bupivacaine. Numerical pain scale scores and amount of opioid usage in morphine milligram equivalences on the first to fourth and eighth postoperative days were collected. We excluded patients from the study who were extubated after the third postoperative day or who were reintubated. RESULTS: One hundred twenty-six patients met the inclusion criteria: 28 in the cryoanalgesia group and 98 in the control group. Preoperative patient demographics were similar in both groups, except for more frequent chronic dissection in patients with cryoanalgesia (93% vs 65%, P = .004). Postoperative major complications, length of stay, and discharge to home were not significantly different in either group. However, median ventilation hours were significantly shorter in the cryoanalgesia group (5 vs 12 hours, P < .001). Opioid use was significantly less in the cryoanalgesia group after postoperative day 4. Indexed morphine milligram equivalences, adjusted with body surface area, and numerical pain scale scores were significantly lower in the cryoanalgesia group throughout the postoperative course. CONCLUSIONS: Intercostal nerve cryoanalgesia under electromyography guidance provided improved pain control and reduced narcotic use after descending and thoracoabdominal aortic aneurysm repairs compared with those who only received paravertebral block.


Assuntos
Analgesia/métodos , Aneurisma da Aorta Torácica/cirurgia , Crioterapia , Nervos Intercostais , Cuidados Intraoperatórios/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
6.
A A Pract ; 14(2): 68, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31833839
7.
Best Pract Res Clin Anaesthesiol ; 33(4): 387-406, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31791558

RESUMO

Pain is a significant consequence of cardiac surgery and newer techniques in cardiac anesthesia have provided an impetus for the development of multimodal techniques to manage acute pain in this setting. In this regard, regional anesthesia techniques have been increasingly used in many cardiac surgical procedures, for the purposes of reducing perioperative consumption of opioid agents and enhanced recovery after surgery. The present investigation focuses on most currently used regional techniques in cardiac surgical procedures. These regional techniques include chest wall blocks (e.g., PECS I and II, SAP, ESB, PVB), sternal blocks (e.g., TTMPB, PSINB), and neuraxial blocks (e.g., TEA, high spinal anesthesia). The present investigation also summarizes indications, technique, complications, and potential clinical benefits of these evolving regional techniques. Cardiac surgery patients may benefit from application of these regional techniques with well controlled indications and careful patient selections.


Assuntos
Anestesia por Condução/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Medição da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Anestésicos Locais/administração & dosagem , Humanos , Nervos Intercostais/efeitos dos fármacos , Nervos Intercostais/fisiologia , Dor Pós-Operatória/etiologia , Nervos Torácicos/efeitos dos fármacos , Nervos Torácicos/fisiologia
8.
Kyobu Geka ; 72(13): 1123-1125, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-31879392

RESUMO

Schwannomatosis with mediastinal vagal schwannoma is rare. A 71-year-old man presented with multiple mediastinal tumors by a regular check-up. A chest computed tomography showed well-defined round tumors along with the 3rd intercostal nerve and in the left upper mediastinal area. A percutaneous biopsy specimen of the tumor suggested benign tumor, however surgical excision was performed for a definitive diagnosis and treatment. The histological diagnosis was schwannoma. Since the tumor originated from the mediastinal vagal nerve proximal to the recurrent laryngeal nerve and was suggested to be benign, it was not resected to preserve the function of the recurrent laryngeal nerve.


Assuntos
Neoplasias dos Nervos Cranianos , Neurilemoma , Neurofibromatoses , Neoplasias Cutâneas , Idoso , Humanos , Nervos Intercostais , Masculino
9.
Am J Phys Med Rehabil ; 98(11): e132-e135, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31626022

RESUMO

Serratus anterior plane block has been used for pain management during the acute period of conditions affecting the thorax, such as postthoracotomy recovery, rib fracture, and breast surgery recovery. Here, we report the use of serratus anterior plane block in posttraumatic chronic pain treatment. We describe a case of posttraumatic chronic intercostal neuralgia, in which successful pain relief was achieved via repeated injections of local anesthetic and steroid combinations in the serratus anterior plane under ultrasonographic guidance. This novel technique is easy to administer, reliable, and warrants further investigation with regard to its use for rehabilitation of patients who are experiencing posttraumatic chronic neuropathies of the chest wall.


Assuntos
Dor Crônica/tratamento farmacológico , Nervos Intercostais/lesões , Bloqueio Nervoso/métodos , Neuralgia/tratamento farmacológico , Ultrassonografia de Intervenção/métodos , Lesões Acidentais/complicações , Acidentes de Trânsito , Dor Crônica/etiologia , Humanos , Masculino , Motocicletas , Neuralgia/etiologia , Manejo da Dor/métodos , Adulto Jovem
10.
Rom J Morphol Embryol ; 60(2): 635-642, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31658338

RESUMO

Performing fetal operations on the walls of the thorax and abdomen requires detailed information dealing with the anatomical variability of the intercostal nerves (IN) in human fetuses. Therefore, our study aimed at determining the topographic and anatomical characteristics of the I-XII IN during the period of human ontogenesis. The study involved 70 specimens of fetuses aged 4-10 months, by means of macromicroscopic preparation, superficial staining of dissected vessels and nerves and morphometry. The variability of the topography and asymmetry of the trunks of IN and their branches were revealed. The direction of the lateral musculocutaneous branches of the inferior IN does not coincide with the direction of the muscle bundles of the external abdominal oblique muscle. The branches of the I IN are functionally different, since the superior branch branches out in the skin and vessels, and the inferior one - in the stratum of the internal intercostal muscle. The anterior musculocutaneous branches of the II-VII IN occur in the front of the parasternal neurovascular bundle and are related with each other, with parasternal nerve or with the nerve plexus of the internal thoracic artery. The trunks of adjacent IN relate to one another by means of rare connecting branches, numerous and diverse in shape links are observed between the anterior and lateral musculocutaneous branches of the VIII-XII IN in the area of the anterior-lateral regions of the abdominal wall. The connecting branches descend from the nodes of the thoracic section of the sympathetic trunk to the IN.


Assuntos
Nervos Intercostais/anatomia & histologia , Fatores Etários , Feminino , Feto , Humanos , Gravidez
11.
Am J Emerg Med ; 37(12): 2263.e5-2263.e7, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31526541

RESUMO

Rib fractures are a common injury, which occur after severe blunt chest trauma. Sufficient and early pain control is essential to avoid respiratory complications. In recent years, the serratus plane and the erector spinae plane blocks have been used in ED for pain related to rib fractures. The Rhomboid Intercostal and Sub-Serratus (RISS) block can be utilized for pain control in patients with multiple rib fractures. We report two cases of patients with multiple rib fractures in which pain reduction was achieved with application of the RISS block.


Assuntos
Bloqueio Nervoso/métodos , Fraturas das Costelas/tratamento farmacológico , Idoso , Anestésicos Locais/administração & dosagem , Feminino , Humanos , Nervos Intercostais , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Medição da Dor
12.
Pain Pract ; 19(8): 866-874, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31273928

RESUMO

BACKGROUND: Advanced tumors of the thoracic spine are difficult to treat and can lead to complex pain syndromes. Following conventional oncologic treatments, pharmacologic therapy may be insufficient to manage pain. Minimally invasive interventional procedures offer alternatives to treat malignant thoracic spinal pain. METHODS: Thirteen patients with metastatic disease and poorly controlled thoracic axial and/or radicular pain were identified via a retrospective chart review. Patients were either treated with radiation, surgery, chemotherapy, or a combination of these. Then, the patients were organized into groups based on their diagnoses, anatomical disease locations, symptoms, prior treatments, and interventional pain procedures offered. RESULTS: All cases of intercostal nerve, costotransverse junction, erector spinae plane, and paravertebral blocks resulted in pain relief without any reported complications. A patient who received a thoracic epidural injection had a complete resolution of pain when combined with radiation therapy 2 weeks after the injection. One patient who underwent repeat thoracic epidural injections eventually had an intrathecal pump placement, resulting in reduced opioid usage. Finally, 1 patient who received a thoracic medial branch block with a relief of thoracic axial pain reported greater pain relief with a medial branch nerve cryoablation. CONCLUSION: We propose a treatment algorithm to manage patients with thoracic spinal tumor-related pain. Interventional thoracic axial procedures may be safe and efficacious pain treatments for patients with cancer.


Assuntos
Anestesia Epidural/métodos , Dor do Câncer/terapia , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Neoplasias da Coluna Vertebral/terapia , Vértebras Torácicas , Adulto , Idoso , Dor do Câncer/diagnóstico por imagem , Feminino , Humanos , Nervos Intercostais/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem
13.
Breast J ; 25(6): 1187-1191, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31264296

RESUMO

Breast cancer is the most commonly diagnosed invasive cancer in women worldwide. While hypoesthesia is a known sequela after mastectomy, patients are now inquiring with renewed interest about the degree and timing of sensation after mastectomy. This is a topic that has generated much research interest. However, while there have been advances in the field, there are few, well-done studies that allow for an accurate answer to this question. In this article, relevant breast and donor site anatomy is reviewed for sensate autologous breast reconstruction. Additional donor sites apart from the typically utilized abdomen are analyzed with relevant anatomical discussions. Outcomes are presented; however, due to the heterogeneity of the patient population, surgical approach and postoperative sensory testing, it is difficult to compare results between studies. Future directions and unanswered questions regarding sensate autologous breast reconstruction are highlighted. While great strides have been made in providing sensate autologous breast reconstruction, there are still many unanswered questions. Thus, the collaboration between surgical teams and sharing of outcomes is crucial to allow for optimization of this powerful surgical approach.


Assuntos
Mama/inervação , Hipestesia/prevenção & controle , Mastectomia/efeitos adversos , Neoplasias da Mama/cirurgia , Feminino , Retalhos de Tecido Biológico/transplante , Humanos , Nervos Intercostais/transplante , Mastectomia/métodos , Complicações Pós-Operatórias/etiologia
14.
Biomed Res Int ; 2019: 1051629, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31236402

RESUMO

Single injections in the anterior region of the thoracic paravertebral space (TPVS) have been reported to generate a multisegmental longitudinal spreading pattern more frequently than those in the posterior region of the TPVS. In this trial, we examined the hypothesis that a continuous thoracic paravertebral block (TPVB) administered through a catheter inserted into the anterior region of the TPVS allows a wider sensory block dispersion. Fifty consecutive patients undergoing video-assisted thoracic surgery were enrolled. Before the surgery, an infusion catheter was inserted into the TPVS through a needle placed adjacent to either the parietal pleura (group A) or internal intercostal membrane (group P) using an ultrasound-guided intercostal transverse approach according to a randomized allocation schedule. A chest radiograph was obtained postoperatively after injection of 10 mL of radiopaque dye through the catheter. Thereafter, 20 mL of 0.375% levobupivacaine was injected via the catheter, followed by commencement of continuous TPVB with 0.25% levobupivacaine at 8 mL/h. The primary outcome was the number of blocked dermatomes at 24 h after surgery. The secondary outcomes included radiopaque dye spreading patterns, the number of segments reached by the radiopaque dye, the number of blocked dermatomes at 2 h after surgery, and pain scores. The median (interquartile range [range]) number of blocked dermatomes 24 h after surgery was 3 (2.75-4 [1-6]) in group A (n = 22) and 2 (1.5-3 [0-7]) in group P (n = 25; p = 0.037). No significant differences in the other outcomes were found between the groups. In conclusion, a continuous TPVB administered using a catheter supposedly inserted into the anterior region of the TPVS allows a wider sensory block dispersion than a catheter inserted into the posterior region of the TPVS. This trial is registered with the UMIN Clinical Trials Registry (UMIN000018578).


Assuntos
Bloqueio Nervoso/métodos , Dor Pós-Operatória/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Vértebras Torácicas/cirurgia , Adulto , Idoso , Cateteres , Meios de Contraste/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Nervos Intercostais/diagnóstico por imagem , Nervos Intercostais/cirurgia , Masculino , Pessoa de Meia-Idade , Agulhas , Dor Pós-Operatória/fisiopatologia , Pleura/diagnóstico por imagem , Pleura/inervação , Pleura/cirurgia , Estudos Prospectivos , Vértebras Torácicas/inervação , Vértebras Torácicas/fisiopatologia , Resultado do Tratamento , Ultrassonografia de Intervenção/métodos
15.
BMC Anesthesiol ; 19(1): 94, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-31164083

RESUMO

BACKGROUND: The ultrasound-guided proximal intercostal block (PICB) is performed at the proximal intercostal space (ICS) between the internal intercostal membrane (IIM) and the endothoracic fascia/parietal pleura (EFPP) complex. Injectate spread may follow several routes and allow for multilevel trunk analgesia. The goal of this study was to examine the anatomical spread of large-volume PICB injections and its relevance to breast surgery analgesia. METHODS: Fifteen two-level PICBs were performed in ten soft-embalmed cadavers. Radiographic contrast mixed with methylene blue was injected at the 2nd(15 ml) and 4th(25 ml) ICS, respectively. Fluoroscopy and dissection were performed to examine the injectate spread. Additionally, the medical records of 12 patients who had PICB for breast surgery were reviewed for documented dermatomal levels of clinical hypoesthesia. The records of twelve matched patients who had the same operations without PICB were reviewed to compare analgesia and opioid consumption. RESULTS: Median contrast/dye spread was 4 (2-8) and 3 (2-5) vertebral segments by fluoroscopy and dissection respectively. Dissection revealed injectate spread to the adjacent paravertebral space, T3 (60%) and T5 (27%), and cranio-caudal spread along the endothoracic fascia (80%). Clinically, the median documented area of hypoesthesia was 5 (4-7) dermatomes with 100 and 92% of the injections covering adjacent T3 and T5 dermatomes, respectively. The patients with PICB had significantly lower perioperative opioid consumption and trend towards lower pain scores. CONCLUSIONS: In this anatomical study, PICB at the 2nd and 4th ICS produced lateral spread along the corresponding intercostal space, medial spread to the adjacent paravertebral/epidural space and cranio-caudal spread along the endothoracic fascial plane. Clinically, combined PICBs at the same levels resulted in consistent segmental chest wall analgesia and reduction in perioperative opioid consumption after breast surgery. The incomplete overlap between paravertebral spread in the anatomical study and area of hypoesthesia in our clinical findings, suggests that additional non-paravertebral routes of injectate distribution, such as the endothoracic fascial plane, may play important clinical role in the multi-level coverage provided by this block technique.


Assuntos
Mama/diagnóstico por imagem , Mama/cirurgia , Nervos Intercostais/diagnóstico por imagem , Nervos Intercostais/cirurgia , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Idoso , Idoso de 80 Anos ou mais , Analgesia/métodos , Mama/anatomia & histologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
A A Pract ; 13(7): 260-263, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31206386

RESUMO

Chronic chest pain is a debilitating condition that is poorly treated, resulting in opioid dependence and significantly decreased quality of life. In this case report, we describe the successful use of 266 mg of liposomal bupivacaine for 4 rounds of left-sided multilevel intercostal nerve blocks performed to treat chronic chest pain of a 21-year-old woman (150 kg, 163 cm). The sensory blockade duration was up to 7 days, analgesia lasted 2 months, and was described superior to that with ropivacaine intercostal blockade. The treatment improved satisfaction with pain control and quality of life.


Assuntos
Bupivacaína/administração & dosagem , Dor no Peito/tratamento farmacológico , Dor Crônica/tratamento farmacológico , Bloqueio Nervoso/métodos , Bupivacaína/uso terapêutico , Feminino , Humanos , Injeções , Nervos Intercostais , Lipossomos , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
18.
Pain Pract ; 19(7): 751-761, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31188514

RESUMO

BACKGROUND: Chronic abdominal pain can be due to entrapped intercostal nerves (anterior cutaneous nerve entrapment syndrome [ACNES]). If abdominal wall infiltration using an anesthetic agent is unsuccessful, a neurectomy may be considered. Pulsed radiofrequency (PRF) applies an electric field around the tip of the cannula near the affected nerve to induce pain relief. Only limited retrospective evidence suggests that PRF is effective in ACNES. METHODS: A multicenter, randomized, nonblinded, controlled proof-of-concept trial was performed in 66 patients. All patients were scheduled for a neurectomy procedure. Thirty-three patients were randomized to first receive a 6-minute cycle of PRF treatment, while the other 33 were allocated to an immediate neurectomy procedure. Pain was recorded using a numeric rating scale (NRS, 0 [no pain] to 10 [worst pain possible]). Successful treatment was defined as >50% pain reduction. Patients in the PRF group were allowed to cross over to a neurectomy after 8 weeks. RESULTS: The neurectomy group showed greater pain reduction at 8-week follow-up (mean change from baseline -2.8 (95% confidence interval [CI] -3.9 to -1.7) vs. -1.5 (95% CI -2.3 to -0.6); P = 0.045) than the PRF group. Treatment success was reached in 12 of 32 (38%, 95% CI 23 to 55) of the PRF group and 17 of 28 (61%, 95% CI 42 to 72) of the neurectomy group (P = 0.073). Thirteen patients were withdrawn from their scheduled surgery. Adverse events were comparable between treatments. CONCLUSIONS: PRF appears to be an effective and minimally invasive treatment option and may therefore be considered in patients who failed conservative treatment options before proceeding to a neurectomy procedure. Anterior neurectomy may possibly lead to a greater pain relief compared with PRF in patients with ACNES, but potential complications associated with surgery should be discussed.


Assuntos
Dor Abdominal/etiologia , Denervação/métodos , Síndromes de Compressão Nervosa/complicações , Síndromes de Compressão Nervosa/terapia , Tratamento por Radiofrequência Pulsada/métodos , Parede Abdominal , Adulto , Feminino , Humanos , Nervos Intercostais/cirurgia , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Medição da Dor , Ondas de Rádio , Pele , Resultado do Tratamento
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