Anestezia dolorosa (olgu sunumu)
Anestezia dolorosa, trigeminal sinir veya dallarına uygulanan ablatif lezyonlar sonrası gelişen bir tedavi komplikasy onudur. Ağrı yanıcı, zonklayıcı nitelikte olup genellikle süreklidir. Anestezia dolorosa için tek basına etkin bir farmakolojik ve invaziv tedavi yöntemi yoktur. Bu nedenle tedavisinde önemli olan gereksiz invaziv işlemlerden kaçınarak insidansını azaltmaktır. İnvaziv işlemlerin gerekliliği ise prognostik blok ile değerlendirilerek saptanmalıdır. Trigeminal nevralji tanısıyla mental blok yapılıp, daha sonra ağrısının devam etmesi üzerine gliserol enjeksiyonu ve nörektomi yapılan 40 yaşındaki olgu, kliniğimize sol alt dudakta şiddetli yanıcı vasıfta ağrı şikayeti ile başvurdu. Olgu anestezia dolorosa tanısıyla tedaviye alındı. Biz bu olgu ile anestezia dolorosanın nedenlerini, tanı ve tedavi prensiplerini incelemeyi amaçladık.
Anesthesia dolorosa (case report)
Anesthesia dolorosa is a complication of ablative lesions of the trigeminal nerve or its branches. Such pain burns and throbs continuously. No pharmacological or ablative surgical treatment is effective for anesthesia dolorosa. For this reason, it is important that unnecessary invasive procedures should be avoided in order to decrease its incidence. The necessity for invasive procedures should be determined by prognostic block evaluation. A forty-year-old man, to whom mental block had been applied, followed by glyserol injection and neuroctomy due to continued pain, was admitted to our pain clinic with a burning sensation in the left region of the lower lip. He was diagnosed as having anesthesia dolorosa. In this case study, our aim was to determine the reasons, principles of diagnosis and treatment of anesthesia dolorosa.
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