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Neuralgia following lumbar sympathectomy
1Service de Chirurgie Cardio-Vasculaire et Thoracique, Cliniques Universitaires UCL de Mont-Godinne, Yvoir, Belgium.
Annals of Vascular Surgery
|July 1, 1988
Summary
Post-lumbar sympathectomy neuralgia can be effectively treated with epidural injections of fentanyl and methylprednisolone. This intervention provided complete pain relief for most patients, offering a reliable solution for this complication.
Area of Science:
- Pain Management
- Neurosurgery
- Pharmacology
Background:
- Unilateral lumbar sympathectomy is a surgical procedure with potential complications.
- Postsympathectomy neuralgia is a recognized adverse event following this surgery, causing significant patient discomfort.
Purpose of the Study:
- To evaluate the efficacy of epidural fentanyl and methylprednisolone for treating postsympathectomy neuralgia.
- To determine the reliability of epidural infiltration as a therapeutic approach for this specific type of nerve pain.
Main Methods:
- A cohort of 33 patients undergoing unilateral lumbar sympathectomy was observed.
- Ten patients who developed postsympathectomy neuralgia received a single epidural injection of 50 micrograms fentanyl and 80 mg methylprednisolone.
Main Results:
- Complete pain resolution was achieved in six out of ten patients after the initial epidural injection.
- Four patients experienced recurrence of neuralgia, necessitating repeat epidural injections which successfully managed residual symptoms.
Conclusions:
- Epidural infiltration with fentanyl and methylprednisolone is a highly effective and reliable treatment for postsympathectomy neuralgia.
- This minimally invasive approach offers significant pain relief and management for patients suffering from this complication.