A case of parasternal intercostal nerve-PRF for anterior chest pain after surgery for a thoracic intramedullary tumor

• Published in: Journal of Japan Society of Pain Clinicians Vol. 30; no. 5; pp. 103 - 106
• Main Authors: NOZAWA, Hiroki, KIMURA, Tetsuro, MIMURO, Soichiro, NAKAJIMA, Yoshiki
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Pain Clinicians 25.05.2023
• Subjects: chronic postsurgical pain; parasternal intercostal nerve block; pulsed radiofrequency
• ISSN: 1340-4903; 1884-1791
• DOI: 10.11321/jjspc.22-0052

Pulsed radiofrequency (PRF) is a safe, minimally invasive, and effective procedure for chronic pain management. We performed parasternal intercostal nerve (PSI)–PRF for anterior chest pain in a patient who underwent thoracic intramedullary tumorectomy. The patient was a 45-year-old man who underwent dura mater closure surgery after thoracic intramedullary tumor (Th2–4) resection. After the surgery, he complained of prolonged left anterior chest pain along the same nerve region. We diagnosed chronic postsurgical neuropathic pain. We performed a PSI block with a single bolus dose, and the patient achieved a pain-free state for several days. We subsequently performed PSI-PRF, and the analgesic effect was sustained for several weeks. Before performing dura mater adhesion surgery, we performed PSI–PRF 20 times every 3–5 weeks for 15 months; there were no associated complications.