The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Pulsed Radiofrequency of Lumbar Dorsal Root Ganglia for Treatment of Chronic Inguinal Herniorrhaphy Pain - A case report -

서혜부 탈장 교정술 후 발생한 서혜부 만성 통증 환자에서 요추 후근 신경절에 시행한 박동성 고주파술을 이용한 치료 - 증례보고 -

  • Kang, Seung Hee (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Han, Hyo Jo (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Won Young (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dae Young (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Moon, Dong Eon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
  • 강승희 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 한효조 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김원영 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김대영 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 문동언 (가톨릭대학교 의과대학 마취통증의학교실)
  • Received : 2007.08.28
  • Accepted : 2007.11.07
  • Published : 2007.12.10
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Abstract

Inguinal hernia repair can result in paresthesia and/or pain in the inguinal region. Pharmacological and surgical management often yield inconsistent results associated with considerable risks and side effects. Radiofrequency thermocoagulation (RF) is a neuro-destructive treatment for severe pain, but associated with hypoesthesia, neuritis-like reactions, and occasional neuroma formation. Pulsed radiofrequency (PRF), unlike RF, delivers high intensity currents in pulses, is non-neurodestructive, and therefore less painful, without the potential complications. Here we report on PRF in chronic postoperative inguinal pain. A 23-year-old male who received right inguinal hernia repair and complained of right sided groin pain for approximately 10 years underwent PRF at the L1 and L2 dorsal root ganglia (DRG). He then reported a decrease in pain from 80-90/100 mm to 15-30/100 mm on a visual analogue scale (VAS), which lasted for twelve months.

Keywords

References

  1. The MRC Laparoscopic Groin Hernia Trial Group: Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 1999; 354: 185-90 https://doi.org/10.1016/S0140-6736(98)10010-7
  2. O'Dwyer PJ. Alani A. McConnachie A: Groin hernia repair: posrbcrniorrhaphy pain. World J Surg 2005; 29: 1062-5 https://doi.org/10.1007/s00268-005-7903-0
  3. Courtney CA, Duffy K, Scrpcll MG, O'Dwyer PJ: Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 2002; 89: 1310-4 https://doi.org/10.1046/j.1365-2168.2002.02206.x
  4. Bay-Nielsen M. Perkins FM. Kehler H; Danish Hernia Database: Pain and functional Impairment I year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 2001; 233: 1-7 https://doi.org/10.1097/00000658-200101000-00001
  5. Rozen D, Parvcz U: Pulsed radiofrequency of lumbar nerve roots for treatment of chronic inguinal herniorrhaphy pain. Pain Physician 2006; 9: 153-6
  6. Cohen SP. Foster A: Pulsed radiofrequcncy as a treatment for groin pain and orchialgia. Urology 2003; 61: 645
  7. Mitra R, Zeighami A, Mackey S: Pulsed radiofrcqueney for the treatment of chronic ilioinguinal neuropathy. Hernia 2007; 11: 369-71 https://doi.org/10.1007/s10029-007-0191-x
  8. Ferzli GS. Edwards ED, Khoury GE: Chronic pain after inguinal herniorrhaphy. J Am Coli Surg 2007; 205: 333-41 https://doi.org/10.1016/j.jamcollsurg.2007.02.081
  9. Bogduk N: Pulsed radiofrcqueney. Pain Med 2006; 7: 396-407 https://doi.org/10.1111/j.1526-4637.2006.00210.x
  10. Bogduk N. Macintosh J, Marsland A: Technical limitations to the efficacy of radiofrcqucncy neurotomy for spinal pain. Neurosurgery 1987; 20: 529-35 https://doi.org/10.1227/00006123-198704000-00004
  11. Sluijter ME, Cosman ER. Rittman WB, van Kleef M: The effects of pulsed radiofrcquency fields applied to the dorsal root ganglion-a preliminary report. Pain Clinic 1998; 11: 109-17
  12. Slappcndel R, Crul BJ, Braak GJ, Geurts JW, Booij LH. Voerman VF, et al: The efficacy of radiofrcqucncy lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between $40^{\circ}C$ and $67^{\circ}C$ treatments. Pain 1997; 73: 159-63 https://doi.org/10.1016/S0304-3959(97)00094-8
  13. Cahana A, Van Zundcn J. Macrea L, van Kleef M. Sluijrer M: Pulsed radiofrequency: current clinical and biological literature available. Pain Med 2006; 7: 411-23 https://doi.org/10.1111/j.1526-4637.2006.00148.x
  14. Higuchi Y, Nashold BS Jr, Sluijter M. Cosman E, Pearlstein RD: Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal hom lamina I and II neurons. Neurosurgery 2002; 50: 850-5 https://doi.org/10.1097/00006123-200204000-00030
  15. Van Zundcrt J, de Louw AJ, Joosten EA, Kessels AG, Honig W, Dederen PJ, et al: Pulsed and continuous radiofrequency current adjacent to the cervical dorsal root ganglion of the rat induces late cellular activity in the dorsal horn. Anesthesiology 2005; 102: 125-31 https://doi.org/10.1097/00000542-200501000-00021
  16. Cha YD : Pulsed radiofrcquency. Korean J Pain 2004; 17 (Suppl): 74-9 https://doi.org/10.3344/kjp.2004.17.S.S74
  17. Cohen SP, Sired A, Wu CL, Larkin TM, Williams KA. Hurley RW: Pulsed radiofrequency of the dorsal root ganglia is superior to phannacotherapy or pulsed radiofrequcncy of the intercostal nerves in the treatment of chronic postsurgical thoracic pain. Pain Physician 2006; 9: 227-35