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ESRA19-0683 Pulsed radiofrequency efficacy on chronic neuralgies after abdominal wall surgery – case series
  1. MJDS Silva,
  2. M Ferreira and
  3. A Agrelo
  1. Instituto Português de Oncologia Francisco Gentil do Porto, IPO-Porto, Anesthesia and Critical Care, Porto, Portugal


Background and aims Chronic postoperative pain (CPOP) is defined as pain at the site of surgery or its referred area, lasting for more than 3 months, after exclusion of other causes. CPOP is due to destruction or entrapment of nerve tissue from sutures, or direct surgical trauma. Multiple approaches to CPOP exist, with varied success rates. Pulsed radiofrequency is a novel approach which focuses on neuromodulation at a local level, that has gained popularity in chronic pain. It differs from conventional radiofrequency because it does not cause tissue destruction, has fewer side effects and complications.

The anterolateral innervation of the abdominal wall is the responsibility of the ventral divisions of the spinal nerves from T6-L1, through the lateral and anterior cutaneous branches. After abdominal wall surgeries, several chronic pain syndromes, as inguinal/hypogastric neuralgia, could result. Also the meralgia paresthetica can arise as the cutaneous femoral cutaneous nerve can also be injured in this track.

Methods In our center chronic neuralgies after abdominal surgery result from oncological procedures, essentially removal of abdominal/pelvic neoplasms and reconstruction after breast surgery. Here we present 5 patients referred to our unit because of chronic pain after oncological abdominal wall surgery. They presented with paresthetic meralgia and ileo-inguinal/ileo-hypogastric neuralgy in which the pharmacological therapy wasn’t effective or had significant side effects.

Results In these patients, RP allowed a sustained reduction of pain, decrease/withdrawal of the regular medication and even discharge of the pain clinic.

Conclusions RP is thus assumed as a minimally invasive alternative for these patients, prior to more invasive options.

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