超声引导神经阻滞联合水分离治疗会阴神经痛1例

Ibrain Pub Date : 2023-11-14 DOI:10.1002/ibra.12138
Yong Wang, Min Wang, Rui Jiang, Zhao‐Qiong Zhu, Guang‐Cai Li
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引用次数: 0

摘要

摘要2020年11月,一名中年男性右侧腹股沟间接疝行腹腔镜右疝囊高位结扎术后1个月,右侧阴囊及大腿内侧皮肤出现间歇性针刺样疼痛,疼痛持续6个月。在超声引导下,采用0.25%利多卡因(6 mL) +醋酸泼尼松龙(10 mg)的混合溶液进行髂腹股沟及生殖股神经阻滞和局部粘连水分离,相同药物和方法重复5次,每周1次。5次治疗后,视觉模拟评分(VAS)由治疗前的7分降至1分。在随访期间,在治疗结束后3个月,VAS评分保持在0,即使在6个月的随访中,该评分仍维持在0。提示超声引导神经阻滞联合水分离技术可有效缓解手术粘连引起的神经痛,对治疗此类疾病具有重要的临床意义。
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A rare case of perineal neuralgia treated with ultrasound‐guided nerve block combined with water separation
Abstract A middle‐aged man experienced intermittent acupuncture‐like pain in the skin of the right scrotum and medial thigh 1 month after undergoing laparoscopic high ligation of the right hernial sac for a right indirect inguinal hernia in November 2020, and the pain persisted for 6 months. Under ultrasound guidance, ilioinguinal and genitofemoral nerve block and local adhesion water separation were performed with a mixture of 0.25% lidocaine (6 mL) plus prednisolone acetate (10 mg), and the same drugs and methods were repeated five times once a week. After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. During the follow‐up period, at 3 months after the end of treatment, the VAS score remained at 0, and this score was sustained at 0 even at the 6‐month follow‐up. These outcomes indicate that ultrasound‐guided nerve block combined with water separation technology can effectively alleviate neuralgia caused by surgical adhesion, which holds important clinical significance in managing such conditions.
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