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Donna Eaton
Omar Maiwand
Vladimir Anikin
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J Thorac Cardiovasc Surg 2010;139:774-775
© 2010 The American Association for Thoracic Surgery

Brief Technique Report

Video-assisted intercostal nerve cryoablation in managing intractable chest wall pain

Ian Hunt, FRCS*, Donna Eaton, FRCS, Omar Maiwand, FRCS, Vladimir Anikin, FRCS

Harefield Hospital, Harefield & Brompton NHS Trust, Harefield, Middlesex, United Kingdom

Received for publication October 12, 2008; revisions received December 13, 2008; accepted for publication December 28, 2008.

* Address for reprints: Ian Hunt, FRCS, Harefield Hospital, Harefield, Middlesex, UB9 6JH United Kingdom. (Email: ianjhunt@gmail.com).

The first 20% of the full text of this article appears below.


   Clinical Summary
 
A 52-year-old women was referred to our unit with severe pain in the right side of the chest, having been kicked in the right flank by a horse 10 years earlier. At the time she sustained fractures to the right 10th, 11th, and 12th ribs and briefly required hospitalization. The pain was sharp and stabbing in nature. Standard oral analgesia including nonsteroidal anti-inflammatory drugs was ineffective. She obtained little relief from opiates and was reluctant to take them long term. Some transient analgesia was obtained through epidurals and intercostal nerve blocks. She had been managed with gabapentin 800 mg twice daily and amitriptyline 25 mg daily long term.

She had no relevant medical history and clinical examination was unremarkable apart from an exquisitely hypersensitive area in the right flank. No obvious deformity was noted, but she had restricted chest wall movement owing to pain. Initial baseline investigations including chest radiograph showed no abnormalities. The rib fractures had healed without deformity. Magnetic resonance imaging revealed no soft . . . [Full Text of this Article]






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