BACKGROUND AND AIMS

To describe the efficacy of PENS to the control of neuropathic pain refractory to conventional treatment.

METHODS

The presented case is a 37-year-old male patient with a medical history of right herniorrhaphy 2 years ago due to indirect inguinal hernia. Despite the surgical treatment, pharmacological therapy and infiltrations of local anesthetics and corticosteroids, he has been suffering pain in the herniated zone extended to the testicle since 3 years ago.

It has been decided to perform PENS. Percutaneously, a needle with electrodes was inserted in the painful area with a 2 cm depth or less, and it was connected to a stimulator that alternates electrical pulses of 2 and 100 Hz every 3 seconds, intensity of 0.5 V for a period of 20 minutes. Previously, a stimulation test was performed, creating a paresthesia in the usual pain area.

RESULTS

A significant improvement of the pain was observed, with a VAS reduction of about 70% in 15 days, considering the therapy successful.

CONCLUSIONS

PENS therapy facilitates the release of different neuropeptides due to the combination of two frequencies of stimulation. It has been used successfully in the treatment of postherpetic neuralgia, trigeminal or occipital neuralgia, among others, with excellent results (Rossi et al., Pain Physician 2016; 19: E121-E128).

This technique is considered minimally invasive and safe, inducing analgesic effects. Therefore, its application is very promising.

USING PERCUTANEOUS ELECTRICAL NEUROSTIMULATION (PENS) TO TREAT REFRACTORY NEUROPATHIC PAIN POSTHERNIORRHAPHY