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Nerve blocks?
Can anyone advise on what kind of nerve blocks are available? Are there any that are intended for relief which last longer, instead of diagnostic ones that wear off quickly?
Thanks in advance.
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7 Replies
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@cshelter
I have experience with several different types of nerve treatment. I’ve had a laparoscopic triple neurectomy which I don’t recommend. It has caused bulging in my lower abdomen. I originally inderatood the nerves to be purely sensory and they aren’t. Most any pain management physician can perform diagnostic nerve blocks in office with an added steroid that may provide longer term relief. That part never worked for me! I have had some luck with the diagnostic portion. As far as ablation goes, there is pulsed Radiofrequency ablation (not too invasive) which I believe pain management offers, as well. I recently had an MRI guided cryoablation treatment, which is performed under general anesthesia (kind of a big procedure) at Johns Hopkins. The MRI allows for a very precise targeted treatment. I had to have successful diagnostic blocks before cryoablation was considered. There has been good success with these treatments, probably some nerves better than others. Unfortunately, for me and my problem, the diagnoatics worked but the ablation treatment didn’t. We tried twice. Only thing left after block failure is neurectomy, which as Dr. Brown says is a major operation. This should be last resort and carefully considered. Hope this helps a little. Feel free to message me if you have any questions. Best wishes! -
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Thank you for your reply again @drbrown
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@cshelter
A nerve ablation only disrupts the nerve at one location. Since the nerves interconnect pain sensation can still back to the brain through these interconnections.
A nervectomy involves removing the nerve. This cuts the interconnections so has a better chance of treating the pain. But it is a major operation.
Regards.
Bill Brown MD -
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Hello @drbrown and @drtowfigh
I was reading about Percutaneous Electrical Nerve Stimulation (PENS) and it is presented as it offers hope for relief. Can either of you, or any other doctors comment on it please? I had not heard of it before and it seems promising. Thanks in advance. -
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@drbrown Can you advise what sort of success rates are achieved by ablation, as a long term solution? Does that mimic the sensation of having had a neurectomy?
At what timeframe someone could be pretty sure it’s not going to improve, left alone? I’m thinking of the IIN.
Is nausea a known effect of IIN disruption or damage?
Thank you Dr Brown.
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Thank you Dr Brown.
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@cshelter
A steroid can be added to the local anesthetic to make it last longer.
The next step would be a nerve ablation.
The last resort would be a neurectomy.
If you have mesh, consider removing the mesh.
Regards.
Bill Brown MD
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