Dima Rozen1, Jane Ahn. 1. Department of Anesthesiology and Pain Medicine, Box 1010, Mount Sinai Medical Center, One East 100th Street, New York, NY 10029-6574, USA. dimarozen@hotmail.com
Abstract
BACKGROUND AND PURPOSE: Ilioinguinal neuralgia secondary to inguinal hernia repair is frequently a chronic, debilitating pain. It is most often due to destruction or entrapment of nerve tissue from staples, sutures, or direct surgical trauma. Treatment modalities, including oral analgesics, nerve blocks, mesh excision, and surgical neurectomy, have varied success rates. Pulsed radiofrequency (PRF) has recently been described as a successful method of treating chronic groin pain. Unlike conventional radiofrequency, PRF is non-neurodestructive and therefore less painful and without the potential complications of neuritis-like reactions and neuroma formation. Although the mechanism is unknown, it appears that the interaction of an electromagnetic field and c-fos proteins may alter normal transmission of painful impulses. Our study examines five patients treated with PRF for ilioinguinal neuralgia secondary to inguinal herniorrhaphy. METHOD: Five patients were diagnosed with chronic ilioinguinal neuralgia secondary to inguinal hernia repair at our institution. Each patient was treated at vertebral T12, L1, and L2 with root PRF at 42 degrees C for 120 seconds per level. RESULTS: Four out of five patients reported pain relief lasting from four to nine months on follow-up visits. Only one patient reported no pain relief whatsoever. CONCLUSION: Ilioinguinal neuralgia is challenging to treat. We have demonstrated the successful use of PRF for four out of five patients seen in our office.
BACKGROUND AND PURPOSE:Ilioinguinal neuralgia secondary to inguinal hernia repair is frequently a chronic, debilitating pain. It is most often due to destruction or entrapment of nerve tissue from staples, sutures, or direct surgical trauma. Treatment modalities, including oral analgesics, nerve blocks, mesh excision, and surgical neurectomy, have varied success rates. Pulsed radiofrequency (PRF) has recently been described as a successful method of treating chronic groin pain. Unlike conventional radiofrequency, PRF is non-neurodestructive and therefore less painful and without the potential complications of neuritis-like reactions and neuroma formation. Although the mechanism is unknown, it appears that the interaction of an electromagnetic field and c-fos proteins may alter normal transmission of painful impulses. Our study examines five patients treated with PRF for ilioinguinal neuralgia secondary to inguinal herniorrhaphy. METHOD: Five patients were diagnosed with chronic ilioinguinal neuralgia secondary to inguinal hernia repair at our institution. Each patient was treated at vertebral T12, L1, and L2 with root PRF at 42 degrees C for 120 seconds per level. RESULTS: Four out of five patients reported pain relief lasting from four to nine months on follow-up visits. Only one patient reported no pain relief whatsoever. CONCLUSION:Ilioinguinal neuralgia is challenging to treat. We have demonstrated the successful use of PRF for four out of five patients seen in our office.
Authors: Danielle M Perret; Doo-Sik Kim; Kang-Wu Li; Karin Sinavsky; Robert L Newcomb; Jason M Miller; Z David Luo Journal: Anesth Analg Date: 2011-05-19 Impact factor: 5.108