Poststernotomy neuralgia: a new pain syndrome. 1989

R J Defalque, and J J Bromley
Department of Anesthesiology, University of Alabama, Birmingham.

Fifty-four patients developed severe intercostal neuralgia a few weeks after sternotomy. Immediate relief afforded by parasternal nerve blocks confirmed that the pain derived from scar-entrapped neuromas of the anterior rami of the first 4-6 intercostal nerves in the upper (and mainly left) interchondral spaces after insertion of the sternal wires. Permanent relief (i.e., over 6 months) followed repeated bupivacaine blocks in 57.4% of the patients, phenol blocks in another 22.2%, and alcohol blocks in a remaining 9%. Treatment was successful in 87% of the patients.

UI MeSH Term Description Entries
D007367 Intercostal Nerves The ventral rami of the thoracic nerves from segments T1 through T11. The intercostal nerves supply motor and sensory innervation to the thorax and abdomen. The skin and muscles supplied by a given pair are called, respectively, a dermatome and a myotome. Intercostal Nerve,Nerve, Intercostal,Nerves, Intercostal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D009437 Neuralgia Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. Nerve Pain,Neurodynia,Paroxysmal Nerve Pain,Neuralgia, Atypical,Neuralgia, Iliohypogastric Nerve,Neuralgia, Ilioinguinal,Neuralgia, Perineal,Neuralgia, Stump,Neuralgia, Supraorbital,Neuralgia, Vidian,Neuropathic Pain,Atypical Neuralgia,Atypical Neuralgias,Iliohypogastric Nerve Neuralgia,Iliohypogastric Nerve Neuralgias,Ilioinguinal Neuralgia,Ilioinguinal Neuralgias,Nerve Neuralgia, Iliohypogastric,Nerve Neuralgias, Iliohypogastric,Nerve Pain, Paroxysmal,Nerve Pains,Nerve Pains, Paroxysmal,Neuralgias,Neuralgias, Atypical,Neuralgias, Iliohypogastric Nerve,Neuralgias, Ilioinguinal,Neuralgias, Perineal,Neuralgias, Stump,Neuralgias, Supraorbital,Neuralgias, Vidian,Neurodynias,Neuropathic Pains,Pain, Nerve,Pain, Neuropathic,Pain, Paroxysmal Nerve,Pains, Nerve,Pains, Neuropathic,Pains, Paroxysmal Nerve,Paroxysmal Nerve Pains,Perineal Neuralgia,Perineal Neuralgias,Stump Neuralgia,Stump Neuralgias,Supraorbital Neuralgia,Supraorbital Neuralgias,Vidian Neuralgia,Vidian Neuralgias
D010149 Pain, Postoperative Pain during the period after surgery. Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D010636 Phenols Benzene derivatives that include one or more hydroxyl groups attached to the ring structure.
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D002921 Cicatrix The fibrous tissue that replaces normal tissue during the process of WOUND HEALING. Scars,Cicatrization,Scar,Scarring
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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