Articles: neuralgia.
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J. Thorac. Cardiovasc. Surg. · Mar 1975
Treatment of intercostal neuralgia with 10 per cent ammonium sulfate.
Intercostal nerves were injected with 10 per cent annomium sulfate in 41 patients (52 total sets of injections) for management of intercostal neuralgia from radical mastectomy (six blocks), thoracotomy (20 blocks), or unknown etiology (26 blocks). Five patients failed to return for follow-up evaluation and could not be located. Sixty per cent (28/47) of the treatments produced complete or nearly complete (excellent) relief of pain. ⋯ Postblock neuritis never occurred. We conclude that intercostal nerve block with 10 per cent ammonium sulfate effectively relieves intercostal neuralgia and is not associated with postblock neuritis. We therefore believe that ammonium sulfate nerve blocks should be administered for treatment of intercostal neuralgia before phenol or alcohol nerve blocks or a surgical procedure.
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Causalgia is a distressing syndrome which should be diagnosed and treated promptly. A presumptive diagnosis can be made on the basis of the existence of burning pain, autonomic dysfunction and atrophic changes. ⋯ Some patients with causalgia may be mistaken for "hysterics" or "malingerers." Treatment may require physical and occupational therapy, analgesics, tranquilizers, sympathetic block or sympathectomy. The merits of adrenergic blocking agents, percutaneous electrical stimulation, dorsal column stimulation and acupuncture are still to be evaluated.