Perineural steroid injections around ilioinguinal, iliohypogastric, and genitofemoral nerves for treatment of chronic refractory neuropathic pain: A retrospective study.

Autor: Sundara Rajan R; Department of Anaesthesia and Pain Medicine, University of North Midlands NHS Trust, Staffordshire, United Kingdom., Bhatia A; Department of Anesthesia and Pain Management, University of Toronto, University Health Network-Toronto Western Hospital, Toronto, Ontario, Canada.; Institute of Health Policy Management and Evaluation, University of Toronto, University Health Network-Toronto Western Hospital, Toronto, Ontario, Canada., Peng PWH; Department of Anesthesia and Pain Management, University of Toronto, University Health Network-Toronto Western Hospital, Toronto, Ontario, Canada., Gordon AS; Division of Neurology, University of Toronto, Wasser Pain Management Center, Mount Sinai Hospital, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Canadian journal of pain = Revue canadienne de la douleur [Can J Pain] 2017 Dec 15; Vol. 1 (1), pp. 216-225. Date of Electronic Publication: 2017 Dec 15 (Print Publication: 2017).
DOI: 10.1080/24740527.2017.1403846
Abstrakt: Background : Perineural local anaesthetic and steroid injections around ilioinguinal (II), iliohypogastric (IH), and genitofemoral (GF) nerves are often performed to treat chronic refractory neuropathic pain in the lower abdomen and groin, but there is a lack of published data on outcomes of these interventions. Aims : The objective of this retrospective study was to evaluate analgesic outcomes of ultrasound-guided II, IH, and GF nerve blocks in patients with chronic neuropathic pain in the lower abdominal wall and groin. Methods : Analgesic outcomes were assessed at 6 weeks after injections and patients were classified as "responders" if the numerical rating scale for pain score reduced by 30% or more. Variables analyzed for impact on outcomes included demographics, intensity of pain and duration, etiology, dose of opioid, presence of anxiety, depression, and diabetes mellitus. Results : In this cohort of 54 patients with severe baseline pain who had failed to receive analgesic benefit from recommended first- and second-line medications for neuropathic pain, 30 patients had history of surgery and 24 had pain secondary to visceral inflammatory pathologies. Twenty-five (46.3%) patients were identified as responders. A majority of the patients in this cohort had pain for more than one year. There was a higher incidence of diabetes mellitus in nonresponders compared to responders but the difference was not significant (14% and 0%, respectively; P  = 0.115). Conclusions : Ultrasound-guided perineural steroids can ameliorate chronic refractory abdominal wall and groin neuropathic pain in patients who have failed to respond to conventional medical management at 6 weeks after the procedures.
Competing Interests: No external funding was used for this study. The authors do not have any conflict of interests relevant to this study.
(© 2017 Rajinikanth Sundara Rajan, Anuj Bhatia, Philip W. H. Peng and Allan S. Gordon. Published with license by Taylor & Francis Group, LLC.)
Databáze: MEDLINE
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