Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Clinical Information

Estimulação medular espinhal para tratamento da polineuropatia dolorosa refratária induzida por quimioterapia

Spinal cord stimulation in the treatment of refractory painful polineuropathy induced by chemotherapy

José Luciano Braun Filho; Leandro Mamede Braun

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JUSTIFICATIVAS E OBJETIVOS: Polineuropatia dolorosa pós-quimioterapia tem sido muitas vezes uma condição refratária ao tratamento clínico conservador. O objetivo deste relato de caso foi mostrar o uso da estimulação medular como técnica alternativa aos métodos convencionais para tratar paciente com quadro doloroso de difícil controle. RELATO DO CASO: Paciente de 72 anos, com polineuropatia dolorosa pós-quimioterapia há mais ou menos dez anos, apresentava dor de forte intensidade (escala analógica visual = 10) em membros inferiores, contínua e diária, apesar do uso de várias medicações específicas para dor neuropática. Foi submetido a implante de eletrodo peridural apresentando melhora significativa das dores (escala analógica visual = 3) e diminuição do uso de medicação. CONCLUSÃO: A estimulação da medula espinhal constitui uma opção terapêutica em pacientes com neuropatia periférica refratária ao tratamento médico convencional quando bem indicada e realizada dentro de critérios estabelecidos.




BACKGROUND AND OBJECTIVES: Painful polyneuropathy after chemotherapy is often refractory to conservative clinical treatment. The objective of this report was to demonstrate that spinal cord stimulation is an alternative to conventional methods used in the treatment of patients with pain that is difficult to control. CASE REPORT: A 72 year old patient with painful polyneuropathy after chemotherapy approximately 10 years ago, presented severe, continuous, daily pain (visual analog scale = 10) in the lower limbs despite the use of several drugs specific for neuropathic pain. An epidural electrode was implanted, with significant improvement in pain (visual analog scale = 3) and reduction in the consumption of medication. CONCLUSION: Spinal cord stimulation constitutes a therapeutic option in patients with peripheral neuropathy refractory to conventional clinical management when properly indicated and within established criteria.




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