1 case of pain after nerve damage in arm plexus with multiple pulsed radiofrequency therapy

Neuropathic pain caused by peripheral nerve injury is a common complication of nerve damage, the mechanism of which is complex, patients often accompanied by depression anxiety, poor treatment effect is a problem that plaguesclinicaldoctorsRadiofrequency technology has achieved some effect in treating pain caused by peripheral nerve damage, but because the site of nerve damage is difficult to determine, it often affects the effect of treatmentThe application of ultrasonic guidance technology has greatly improved the therapeutic effectRecently, my department used ultrasound guidance technology to the arm plexus nerve damage after the pain of patients with multiple pulse radio frequency therapy, the effect is good, is reported as follows:Zeng, male, 56 years old, 20 years ago because of a car accident injury in the hospital on the right arm plexus nerve injury repair surgery, after the recovery is still possible, after the patient appeared in the upper limb pain, pain tingling, accompanied by numbness, gradually appearupper muscle atrophy, the pain gradually increasedOral meloxicon, seroxetine, qumado and gabadin, poor pain control, physical examination: right upper limb muscle atrophy, muscle strength level 1, sensory decline, visual analoge scale score (visual analoge scale, VAS): 8 points, anxiety self-assessment scale (self-rating anxietyscale, SAS): 4 points, ultrasound under the eyes of the arm muscle strain nerves, severe anatomy (see figure 1)Figure 1 Ultrasound lower arm plexus nerve adhesion (the adhesion arm plexus nerve in the dotted line)Treatment after: oral meloxikon 7.5mg, 1 daily, oxycodone 1mg, 1 daily, gaba din0 0.3g, 3 times dailyradiofrequency therapy in ultrasound-guided downstream pulses (see Figure 2)Figure 2 RF needle reaches arm plexus nerve (arrow marked puncture needle)puncture diner needle type under ultrasonic guidance to arm plexus nerve position, neuroimpedance test using Huaxia Corning RF instrument (Anko ASA-601TP RF meter) at 380 ohms, Nerve sensory and motion testing, further determined around the nerve, take standard pulserf, temperature 42 degrees C, time 360s, after the rftort local injection compound double hemisone 1.5 mg, methylcobalamin 0.5 mg, 2% Lidocain 1 ml, extraction of rfradio needleThe next day the patient complained about the pain of thumb site significantly reduced, VAS score 6 points, five days between the second ultrasound guided pulse radio frequency therapy, temperature 42 degrees, time 360 seconds, radiofrequency treatment after the patient complained of small finger pain reduction, VAS score 4 pointsdiscontinued oxycodone, the patient's pain score remained at about 3 to 5 points, followed by the third line of ultrasound guided pulse radio frequency therapy, the method with the second time, the patient's pain significantly reduced, VAS score 2 points, the discontinuation of meloxiconFor three days, patients scored 1 to 3 on VAS and 1 on SAS Stop gaba spray and the patient is discharged from the hospital The patient's pain reappeared in a month, came to the hospital for treatment, VAS score 7 points, the patient again performed ultrasound-guided pulse radiofrequency therapy, treatment with the second treatment, after the patient's treatment VAS score of 5 points, followed by radiofrequency therapy 7 times, the patient total pulsed radio frequency therapy 11 times The patient's VAS score was gradually reduced to 1 point In this patient follow-up March, the patient VAS score 0 to 1 armband nerve damage is a common nerve injury in clinical Abnormal discharge of neurons in the damaged area after peripheral nerve damage causes peripheral neurosensitivity and thus pain Patients with nerve damage are often chronically associated with neuropathic pain Neuropathic pain after nerve damage is a common clinical pain often accompanied by different degrees of depression Because of the complex mechanism of nerve injury pain, there are many drugs for the treatment of neuropathic pain in clinical practice, but the effect of simple drug treatment is not good abnormal signals can be seen in the site of nerve damage in the ultrasound image, and the study shows that ultrasound technology is used for nerve fascia injury diagnosis better than mrimagnetic resonance Under ultrasound, the patient's arm plexus nerves were seen to be adhesion severely, scars around the arm plexus nerves increased, and local inflammatory responses were obvious, which may be one of the causes of neuropathic pain Ultrasound guidance technology promotes the development of pain minimally invasive treatment, pierces the arm plexus nerve under ultrasonic guidance, and adjusts the needle tip in different parts of the arm plexus nerve according to the result of sensory and motor stimulation to achieve the goal of precision treatment pulsed radiofrequency treatment pain is widely used in clinical use, it emits high-frequency alternating current, the needle temperature does not exceed 42 degrees, in the nerve around the formation of a high voltage, thereby playing a role in regulating pain The effect of pulse radiofrequency therapy for neuro-injury pain has been reported, and The study of Xiaolin shows that pulseradio therapy for neuro-injury pain has a clear clinical effect The use of pulsed radio frequency also achieved good results However, although a single pulse of radio frequency can regulate pain, its regulation of pain is not long The patient has had nerve damage in his arm for nearly two decades, and traditional treatments have been largely ineffective the patient's analgesic score decreased significantly after pulsed radiofrequency therapy under ultrasound guidance, consistent with previous studies, pulsed radio frequency can treat peripheral nerve damage pain, this patient pulsed radio frequency three times to achieve better clinical results, probably because the patient's arm plexus nerve damage around the scar growth significantly affected the pulse rfonation effect Endine studies showed significant changes in the neural superstructure of mice during the pulseof radio frequency in the sciatic nerves of mice for ten consecutive days This patient used pulseradio treatment 11 times, follow-up in March patients basically in painless state, indicating that pulse rfonics in the neuropathic pain treatment process can play a role in nerve regulation, continuous pulse stimulation can change the change of neuroplasticity, which is debatable, but after eleven pulse rfonic therapy did play a very good role, the mechanism is worth further exploration