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首页> 美国卫生研究院文献>Toxins >Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
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Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain

机译：超声引导的A型肉毒毒素神经阻滞治疗顽固性神经性疼痛

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Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA) into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.
机译：神经性疼痛包括带状疱疹后神经痛（PHN），疼痛性糖尿病性神经病（PDN）和三叉神经痛，等等。尽管已经尝试了各种药物来治疗神经性疼痛，但是由于不希望的严重副作用和潜在疾病本身，药物有时对于慢性顽固性神经性疼痛可能是有限的，特别是当它们不能以足够的剂量使用时。已知A型肉毒毒素（BoNT-A）在各种疼痛情况下具有镇痛作用。但是，PHN和PDN中没有神经阻滞的数据。在这里，我们报道了两名使用BoNT-A进行超声引导的周围神经阻滞成功治疗顽固性PHN和PDN的患者。一名患者左上肢PHN，另一名患者下肢PDN。由于药物的副作用，无法增加药物剂量。我们在超声下分别向臂丛和腰丛注射了50个肉毒杆菌素单位（BOTOX ®，Allergan Inc.，Irvine，CA，美国）。在大约4到5个月的时间内，他们的疼痛明显减轻。在慢性顽固性神经性疼痛中，BoNT-A超声引导的神经阻滞可能是一种有效的镇痛方法，尤其是当常规治疗未能充分缓解疼痛时。

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