Pulsed radiofrequency lesioning at multiple trigger points around the scar for management of chronic persistent postsurgical neuropathic pain following total abdominal hysterectomy and laparotomy

Abstract

Chronic persistent postsurgical pain (CPPP) is a common complication following surgery. If a pain persists for >3 months following surgery and cannot be explained by any other causes, then it is labeled as CPPP. The mechanism is not fully understood. A 35-year-old female presented with chronic persistent postsurgical neuropathic pain following total abdominal hysterectomy and gynecological laparotomy. Multimodal integrated approach for the management of pain was adopted. After having no relief with oral pregabalin therapy, the patient was then planned for pulsed radiofrequency (PRF) lesioning at multiple trigger points along the scar. The patient was followed up to 6 months after the second PRF procedure. After 2 months following the PRF procedure, the Numerical Rating Scale score improved from 9/10 to 2/10.

Keywords

• Chronic persistent postsurgical pain
• Numerical Rating Scale
• pulsed radiofrequency