Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy
Introduction Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhe...
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| Format: | Article |
| Language: | English |
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Institute of Rural Health
2015-05-01
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| Series: | Annals of Agricultural and Environmental Medicine |
| Subjects: | |
| Online Access: | http://www.journalssystem.com/aaem/Pharmacological-treatment-and-regional-anesthesia-techniques-for-pain-management,72289,0,2.html |
| _version_ | 1818606716015607808 |
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| author | Małgorzata Malec-Milewska Bartosz Horosz Agnieszka Sękowska Iwona Kolęda Dariusz Kosson Grzegorz Jakiel |
| author_facet | Małgorzata Malec-Milewska Bartosz Horosz Agnieszka Sękowska Iwona Kolęda Dariusz Kosson Grzegorz Jakiel |
| author_sort | Małgorzata Malec-Milewska |
| collection | DOAJ |
| description | Introduction
Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions.
Objective
Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions.
Material and Methods
18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin).
Results
In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms.
Conclusions
The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther) and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy. |
| first_indexed | 2024-12-16T14:15:16Z |
| format | Article |
| id | doaj.art-d4f1e705c1ee4ad5b225981ea89b8d64 |
| institution | Directory Open Access Journal |
| issn | 1232-1966 1898-2263 |
| language | English |
| last_indexed | 2024-12-16T14:15:16Z |
| publishDate | 2015-05-01 |
| publisher | Institute of Rural Health |
| record_format | Article |
| series | Annals of Agricultural and Environmental Medicine |
| spelling | doaj.art-d4f1e705c1ee4ad5b225981ea89b8d642022-12-21T22:28:37ZengInstitute of Rural HealthAnnals of Agricultural and Environmental Medicine1232-19661898-22632015-05-0122235335610.5604/12321966.115209472289Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategyMałgorzata Malec-Milewska0Bartosz Horosz1Agnieszka Sękowska2Iwona Kolęda3Dariusz Kosson4Grzegorz Jakiel5Pain Clinic, Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, PolandPain Clinic, Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, PolandPain Clinic, Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, PolandPain Clinic, Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, PolandPain Clinic, Department of Anaesthesiology and Intensive Care, Medical Centre for Postgraduate Education, Warsaw, Poland1 st Department of Obstetrics and Gynaecology, Medical Centre for Postgraduate Education, Warsaw, PolandIntroduction Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions. Objective Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions. Material and Methods 18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin). Results In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms. Conclusions The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther) and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy.http://www.journalssystem.com/aaem/Pharmacological-treatment-and-regional-anesthesia-techniques-for-pain-management,72289,0,2.htmlchronic pelvic pain syndromeendometriosispelvic adhesionsamitriptylinegabapentinpudendal nerve blockganglion of Walther |
| spellingShingle | Małgorzata Malec-Milewska Bartosz Horosz Agnieszka Sękowska Iwona Kolęda Dariusz Kosson Grzegorz Jakiel Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy Annals of Agricultural and Environmental Medicine chronic pelvic pain syndrome endometriosis pelvic adhesions amitriptyline gabapentin pudendal nerve block ganglion of Walther |
| title | Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| title_full | Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| title_fullStr | Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| title_full_unstemmed | Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| title_short | Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| title_sort | pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy |
| topic | chronic pelvic pain syndrome endometriosis pelvic adhesions amitriptyline gabapentin pudendal nerve block ganglion of Walther |
| url | http://www.journalssystem.com/aaem/Pharmacological-treatment-and-regional-anesthesia-techniques-for-pain-management,72289,0,2.html |
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