Approach of neuropathic pain | general surgeon - Murcia

Effective treatment for neuropathic pain, difficult disease to deal

Written by: Dr.Prof. Alfredo Moreno Egea
Published: | Updated: 15/08/2018
Edited by: Patricia Pujante Crespo

Neuropathic pain is very difficult to treat and a challenge for medical professionals. It is a chronic and severe pain experienced by some people due to nerve injury. The most common cause is related to neural injuries that occur after surgery or trauma.

Neuropathic pain: what is

Neuropathic pain is a condition in which people suffer from severe chronic pain due to damage or injury to a nerve. Therefore, it is a pain and a problem of neural origin. This damage can be caused by many causes, such as nutritional or neural disorders, infections, autoimmune diseases, etc.. However, most often the neural injury that occurs during surgery or previous trauma (car accident scar fall, etc.).

The refractory or intractable groin pain is one of the most complex problems that can occur to a doctor. Many people have visited many pain specialists without relief to his groin pain for years.

 

Where neuropathic pain occurs

Although there are many causes which interest has for surgery for possible treatment is caused by a previous operation. The most typical is a man or woman a hernia operation with a mesh and, a few days after surgery, begins with a pain that does not respond to normal painkillers. It is also very common after a caesarean section, appendectomy, gynecological incision or trauma to the pelvis or fractures.

 

Causes and symptoms of neuropathic pain

Neuropathic pain occurs after a peripheral nerve injury. For example, after a hernia operation, the ilioinguinal nerve is injured (burn, by suture or fibrosis when contacting mesh). Nerve neurons become sensitive and develop an abnormal spontaneous activity, excitability and increased sensitivity to any chemical, thermal and mechanical stimulus (the touch, cold or heat, clothing, etc.). This phenomenon is called allodynia (innocuous stimulus when the intense pain reaction occurs) and hyperalgesia (noxious stimulus when mild reaction produces intense pain).

Neuropathic pain can occur continuously or in the form of episodes (paroxysmal). The latter resemble an electric shock. It is often referred to as a burning or coldness, spiking feelings of pins and needles, numbness and itching.

How to diagnose neuropathic pain

The diagnosis must be performed by a specialist, and is based on the presence of:- Stinging or burning scar on the inside of the thigh irradiation or public tuber.- Alteration of sensory perception, whether distesia, hiperostesia or hypoesthesia in the territory of the affected nerve.- Pain relieved after anesthetizing the acreages to innervation, which is the most important to request surgery safely test.

 

Treatment of neuropathic pain and results

Neuropathic pain can be very difficult to treat. First it is necessary for your doctor to reach a more or less sure what diagnosis is what is happening and what is the origin of nerve injury. Determine the best treatment remains a challenge. Multidrug treatments are temporary and not definitive. If the diagnosis is reliable, anesthetic infiltration or blocks are useful, but the best form of treatment is neurectomy or final section of the injured nerve.

The laparoscopic approach by an expert in General Surgery is very attractive because it avoids damaged tissues and offers a panoramic view of the extraperitoneal inguinal region, being able to explore all the nerves with equal access. It is performed under general anesthesia and has one hour, approximately. It works with three trocars and nerves are cut safely and sent to histological study.

Only requires a day of hospitalization, performing as outpatient surgery 23 hours. The next day he discharged the patient and can perform all activities without limitation. Invites no treatment or diet. The pain disappears immediately and forever.

 

Edited by Patricia Crespo Pujante

*Translated with Google translator. We apologize for any imperfection

By Dr.Prof. Alfredo Moreno Egea
Surgery

Dr. Alfredo Moreno Egea is Doctor "Cum Laude" in Medicine and Surgery, Academic Correspondent and Professor of Surgery. Has over 25 years experience in the specialty, being instructor Laparoscopic Surgery for other novice surgeons and residents, Wall Unit Coordinator Abdominal Hernia Diploma from the University of Monterrey, and Secretary General of the Spanish-American Hernia Society. He has published more than 200 scientific articles in prestigious journals, both national and international (as first author), has participated in numerous conferences and meetings as an expert, it belongs to the Editorial Board of numerous journals and is a regular speaker at conferences specialty. He is currently Head of the Hernia Clinic referral center for troubleshooting the abdominal wall (Hernia) of abdominal contouring (tummy tucks) and treat post-surgical inguinal nerve pain (neurectomy), among other conditions.

*Translated with Google translator. We apologize for any imperfection

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