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Coblation of Femoral and Sciatic Nerve for Stump Pain and Phantom Limb Pain: A Case Report
Author(s) -
Zeng Yuanjie,
Wang Xiaoping,
Guo Yuna,
He Liangliang,
Ni Jiaxiang
Publication year - 2016
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12400
Subject(s) - medicine , neuroma , phantom pain , phantom limb pain , sciatic nerve , neuropathic pain , anesthesia , surgery , phantom limb , femoral nerve , analgesic , amputation
Background There is currently no reliable treatment for stump pain and phantom limb pain. Peripheral factors play a significant role in the pathophysiology of stump pain and phantom limb pain. Coblation technology is a relatively new technology that has shown promise in treating neuropathic pain. Case Report This report describes the use of coblation technology on femoral and sciatic nerve for stump pain and phantom limb pain. An ultrasound‐guided perineural infiltration anesthesia surrounding the neuroma was first performed and achieved approximately 60% stump pain relief that lasted for 2 hours, but no relief of the phantom limb pain. An ultrasound‐guided femoral and sciatic nerve block was performed to obtain longer pain relief. The patient reported approximately 80% pain relief in both stump pain and phantom limb pain that lasted for 40 hours. This finding suggested other factors in addition to the ultrasound‐detected neuroma in the residual limb generating pain for this patient. Coblation of femoral and sciatic nerves was performed. The stump pain was completely relieved immediately after operation. At 1, 3, and 6 months postoperative review, 80% relief of both stump and phantom limb pain was achieved. Overall activity was improved and there was no need for pain medications. The analgesic effect was stable during the 6‐month follow‐up period. Conclusion Our report suggests that coblation technology may be useful treatment for stump pain and phantom limb pain. Treatments focusing on peripheral nerves may be more effective than those focusing on the neuroma. This finding needs additional study for confirmation.