Abstract
OBJECTIVES:Alcohol for intercostal neuralgia may induce severe injection pain. Although nerve block provided partial pain relief, alcohol might be diluted, and the curative effect decreased when the local anesthetic and alcohol were given at the same point. Therefore, we observed the modified method for intercostal neuralgia, a Two-point method, in which the local anesthetic and alcohol were given at different sites.METHOD:Thirty patients diagnosed with intercostal neuralgia were divided into 2 groups: Single-point group and Two-point group. In the Single-point group, alcohol and local anesthetic were injected at the same point, named the “lesion point”, which was the lower edge of ribs and 5 cm away from the midline of the spinous process. In the Two-point group, alcohol was injected at the lesion point, whereas the local anesthetic was administered at the “anesthesia point”, which was 3 cm away from the midline of spinous process.RESULTS:After alcohol injection, visual analog scale (VAS) in the Two-point group was lower than the Single-point group, and the satisfaction ratio of patients in the Two-point group was higher (p<0.05). The degree of numbness in the Two-point group was greater than the Single-point group at 1 month and 3 months after operation (p<0.05). However, the long-term effects did not differ.CONCLUSIONS:Local anesthetic was given upstream of the point where alcohol was administered, was a feasible and safe method to relieve pain during the operation, and improved the satisfaction of the patients and curative effect.
Highlights
Intercostal neuralgia refers to thoracic and abdominal pain with a zonal distribution caused by intercostal nerve impairment, which can be induced by different stimuli, such as trauma, tumor, neuroma, or herpes zoster [1,2]
The results showed that the Two-point method decreased the visual analog scale (VAS) score, mean arterial pressure (MAP), and heart rate (HR) during the operation and improved the satisfaction of patients compared with the Single-point method
Nerve block upstream of the nerve lesion point decreased the acute pain induced by alcohol during the operation and improved the patients’ satisfaction and the long-term curative effect
Summary
Intercostal neuralgia refers to thoracic and abdominal pain with a zonal distribution caused by intercostal nerve impairment, which can be induced by different stimuli, such as trauma, tumor, neuroma, or herpes zoster [1,2]. Intractable intercostal neuralgia often manifests as a sharp or burning pain accompanied by exacerbation when coughing and sneezing, and pain to the touch [2], which significantly reduces the quality of life. Many methods have been adopted to treat intractable intercostal neuralgia, including drugs [3], nerve block [4,5,6], and pulsed radiofrequency [7]. Received for publication on April 9, 2019. Accepted for publication on November 14, 2019
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