Treatment for persistent chronic neuralgia after inguinal hernioplasty

Palumbo, Piergaspare; Minicucci, Alessia; Nasti, Aniello Gennaro; I, Simonelli; Vietri, F; Angelici, A

doi:10.1007/s10029-007-0268-6

Cited by 27 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent scoping review on perineural steroids for the treatment of chronic post-herniorrhaphy groin pain 23 identified four case series that reported analgesic efficacy of perineural steroids around II, IH, and GF nerves in patients with CPSP following inguinal herniorrhaphy. [18][19][20][21] All of the studies reported an analgesic benefit with this intervention with a reduction in pain NRS scores by 55%-75%. However, there was heterogeneity in doses of steroids, number of injections (varying from one to seven), and interval between intervention and follow-up (one to 68 months).…”

Section: Discussionmentioning

confidence: 99%

“…16,17 There is some evidence for analgesic efficacy of injections of perineural steroids around IH and II nerves, but the published studies are heterogeneous with methodological limitations. [18][19][20][21] Existing literature is unable to provide a reliable estimate of analgesic outcomes of these procedures. There is a paucity of reliable data about the nature of pain syndromes and characteristics of patients who undergo these interventions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Rajan

Bhatia

Peng

et al. 2017

Canadian Journal of Pain

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Rajan

Bhatia

Peng

et al. 2017

Canadian Journal of Pain

View full text Add to dashboard Cite

show abstract

“…A stepwise approach to treatment, starting with the least invasive options, is recommended. 143 Although we know that the predominant mechanism for chronic postoperative pain is neuropathy following the sensitization of nerve endings of the ilioinguinal and iliohypogastric nerves, it is essential to establish the probable physiological background, e.g., hyperalgesia following nerve instrumentation, and to treat symptoms accordingly via pharmacological agents, physiotherapy, stimulation techniques, or cognitive therapy. Adjuvant pharmacological therapy may be initiated in the primary setting.…”

Section: Strategy For Treatment Of Postoperative Pain and Perspectivesmentioning

confidence: 99%

Pain following the repair of an abdominal hernia

2009

View full text Add to dashboard Cite

Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects the individual patient, but may also have a great impact on relatives and society, and may be a cause of concern for the responsible surgeon. This paper provides an overview of the anatomy, surgical procedures, and disposing factors (age, gender, ethnicity, genotype, previous hernia repair, pain prior to surgery, psychosocial characteristics, and surgical procedures) related to the postoperative pain conditions. Furthermore, the mechanisms for both acute and chronic pain are presented. We focus on inguinal hernia repair, which is the most frequent type of abdominal hernia surgery that leads to chronic pain. Finally, the paper provides an update on the diagnostic and treatment routines for postoperative pain.

show abstract

“…Other non-controlled nerve block studies in PIPP-patients have also shown analgesic responses with LA and have been used for identifying patients for neurectomy, 19 neurolysis 20 or as a treatment on its own. 21 However, significant interpretation is impeded by the lack of controls as the observed effects could be because of placebo and/or dry needling effects.…”

Section: Nerve Blockadementioning

confidence: 99%