Phrenic Nerve Blockade to Diagnose and Treat Diaphragmatic Pain After Surgical Repair of Congenital Diaphragmatic Eventration

Sujana Dontukurthy, Saptarshi Biswas, Sudhakar Kinthala, Waala Housny, Joseph D. Tobias

Abstract


A 46-year-old woman presented with pain in the lateral side of the left chest wall and a sensation of fullness and pulling in the epigastric region, which started 4 weeks following diaphragmatic plication for left diaphragmatic eventration. The patient was diagnosed as suffering from post-thoracotomy pain syndrome (PTPS). A diagnostic intercostal nerve block relieved the chest wall pain, but not the epigastric pain. After a detailed evaluation, the epigastric pain was postulated to be of diaphragmatic origin and hence a diagnostic phrenic nerve block was performed which relieved the epigastric pain. Combined intercostal nerve neurolysis and phrenic nerve block relieved her pain completely. The phrenic nerve may play a role in pain transmission and the genesis of chronic pain following diaphragmatic surgery. Diaphragmatic pain following surgery may contribute to the development of chronic pain. Phrenic nerve blockade provides diagnostic information regarding the etiology of pain as well as being effective in providing analgesia. The technique of phrenic nerve block is presented and its role in the diagnosis and treatment of pain following thoracic surgery is reviewed.




J Med Cases. 2020;11(4):94-96
doi: https://doi.org/10.14740/jmc3436

Keywords


Diaphragmatic plication; Thoracic surgery; Diaphragmatic eventration; Chronic pain; Post-thoracotomy pain syndrome; Intercostal nerve block; Phrenic nerve block; Diaphragmatic pain

Full Text: HTML PDF
 

Browse  Journals  

 

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

 

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

 

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

 

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

 

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 
       
 

Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.journalmc.org   editorial contact: editor@journalmc.org    elmer.editorial@hotmail.com
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.


Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.