[Iatrogenic peripheral nerve injury; mechanism and therapy].
The pain remaining after a needle stick is categorized as neuropathic pain. CRPS (Complex Regional Pain Syndrome) is a typical disease in this category. Neuropathic pain is extremely intractable when it becomes chronic pain, inducing psychological and physical pain in patients over a long period of time. Neuropathic pain is a complex system caused by various factors, and its mechanism remains unclear. For prevention, medical practioners should carefully select centesis, and apply necessary measures corresponding to the situation. There is no established treatment for neuropathic pain. We usually treat the disease with nerve block and drug therapy. Nerve block is useful for pain relief. We typically use a sympathetic nerve block (SGB; stellate ganglion block, IRSB; intravenous regional sympathetic block et. al.) as the initial treatment. In the stage of chronic pain, it is very important to improve patients' ADL (activity of daily living) and QOL (quality of life). If neuropathic pain is suspected, it is crucial to treat at an early stage. Therefore, it should be emphasized that when pain persists after a needle stick, the patient should immediately consult a pain clinician or an orthopedist.
Tanabe
Yutaka
Y
Department of Anesthesiology, Juntendo University School of Medicine, Bunkyo ku, Tokyo.
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001340:Autonomic Nerve Block / Q000379:methods*; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000150:complications*; D019635:Neurosurgical Procedures; D059348:Peripheral Nerve Injuries
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids