Acute neuropathic pain after surgery: Are we treating them early/late?

Abstract

Summary Acute neuropathic pain (ANP) is now recognised as a cause of post surgical pain. We describe an 80 year old female who presented with sciatic nerve injury following a total hip replacement surgery. Clinical presentation included acute neuropathic pain, numbness, paraesthesia and foot drop. Symptoms and signs of nerve injury and pain were confirmed by neurophysiological studies to be due to a proximal sciatic nerve lesion. Its aetiology, pathogenesis, diagnosis and pharmacotherapy is discussed. In conclusion, we had a patient who demonstrated acute post operative neuropathic pain in combination with post surgical nociceptive pain after hip surgery. ANP responded well to Amitriptyline and Gabapentin. Early diagnosis and treatment with antineuralgics is recommended to prevent progression to chronic post operative neuropathic pain. However, clinical trials are required to confirm efficacy of these treatments in acute neuropathic pain.