Peripheral nerve stimulation

Anterior cutaneous nerve entrapment syndrome (ACNES) is a cause of moderate to severe chronic pain, hyperesthesia/hypoesthesia, and altered perception of heat/cold in a specific region of the anterior abdominal wall, referable to the territory of innervation of one or more anterior branches of the intercostal nerves. None of the therapeutic options currently available has proved to be effective in the long term or decisive. In recent years, we have begun to treat purely sensory neuropathies, such as this, with the implantation of wireless peripheral nerve stimulators (PNS), achieving the safety of modular and personalized analgesia. We report the case of a 41-year-old man suffering from ACNES of the 8th intercostal nerve for two years. We first performed two consecutive ultrasound-guided diagnostic blocks of the anterior cutaneous branch of the 8th intercostal right nerve and then elected the patient for ultrasound-guided nerve decompression followed by neuromodulation and pulsed- radiofrequency (PRF). Taking into account full employment, young age, and the likelihood of having to repeat the treatment several times, we considered him for Peripheral Nerve Stimulation (PNS) implantation under ultrasound guidance, and we implanted the wireless lead at the anterior branch of the right 8th intercostal nerve, and programmed tonic stimulation 100 Hz PW 200 ms. The patient reported immediate pain relief and never took medication for this problem again, at two years follow-up. PNS has had an increasing role in the management of chronic neuropathic pain, especially in merely sensitive neuropathies like ACNES. We support future research on this theme. Keywords: ACNES; chronic pain; modular analgesia; peripheral nerve stimulation; radiofrequency. Anterior kutanoz sinir sikijma sendromu (ACNES), ozgul bir anterior karin duvari bolgesinde, orta ila ciddetli kronik agri, hiperestezi/hipoestezi ve isi/soguk algisinda degiciklige sebep olan, bir veya daha fazla interkostal sinirin on dallarinin innerve ettigi bolgeye atfedilebilen bir durumdur. Ju anda mevcut olan tedavi seceneklerinden hicbiri uzun vadede veya kesin olarak etkili olmamijtir. Son yillarda, bu gibi saf duyusal noropatileri, kablosuz periferal sinir stimulatorleri (PNS) implantasyonu ile tedavi etmeye bacladik, moduler ve kicisellectirilmic analjezi guvenligine ulactik. iki yildir 8. interkostal sinirin ACNES'inden muzdarip 41 yajinda bir erkek hastanin vakasini rapor ediyoruz. ilk olarak, 8. interkostal sag