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Case Report

Clinical Pain 2019; 18(1): 36-39

Published online June 30, 2019

Copyright © Korean Association of Pain Medicine.

Ultrasonography-Combined with Nerve Stimulator Technique for Injection of the Genitofemoral Nerve in a Patient with Chronic Postoperative Inguinal Pain

수술 후 서혜부 만성 통증에서 신경 자극기를 이용한 초음파 유도하 음부대퇴신경 차단술

Young-Bin Oh, M.D., Ph.D.1, Hyun Baek Shin, M.D., Ph.D.4, Myoung-Hwan Ko, M.D., Ph.D.1,2,3,Jeong-Hwan Seo, M.D., Ph.D.1,2,3 and Gi-Wook Kim, M.D., Ph.D.1,2,3

오영빈1ㆍ신현백4ㆍ고명환1,2,3ㆍ서정환1,2,3ㆍ김기욱1,2,3

1Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, 2Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, 3Translational Research and Clinical Trials Center for Medical Devices, Chonbuk National University Hospital, 4Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea

전북대학교 의과대학 재활의학교실1, 전북대학교병원 임상연구센터2, 전북대학교병원 의료기기중개 임상시험지원센터3, 전북대학교 의과대학 외과학교실4

Received: July 20, 2018; Accepted: October 9, 2018

Abstract

Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

KeywordsGenitofemoral nerve, Nerve stimulator, Chronic postoperative inguinal pain

Korean Association of Pain Medicine

Vol.23 No.2
December 2024

eISSN: 2765-5156

Frequency: Semi Annual

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