Work

Innovative “Three-in-One” Method for Intervention of Lower Limb Neuropathic Pain: Retrospective Case Series Study

Year: 2025

Type: article

Abstract: Purpose: Minimally invasive intervention therapy anterior cutaneous branch of the femoral nerve for refractory neuropathic pain in the inner thigh area typically requires punctures at multiple sites to target the three nerves of the obturator nerve cutaneous branch, anterior cutaneous branch of the femoral nerve, and infrapatellar branch of the saphenous nerve. Clinical practice has demonstrated that the innovative “three-in-one” technique allows for simultaneous targeting of the three cutaneous nerves from a single entry point, effectively treating inner thigh pain. Moreover, this approach can also be used for local anaesthesia in shallow surgical procedures in the inner thigh area. We hope to promote this puncture technique among pain physicians. Patients and Methods: Clinical data of 8 patients with localized pain in the inner thigh from the Pain Department of Taihe Hospital, Shiyan City, Hubei Medical College, from April 2023 to September 2024 were collected. All the patients experienced pain in the cutaneous branch of the obturator nerve, the anterior branch of medial femoral cutaneous nerve, and the infrapatellar branch of the saphenous nerve. The “three-in-one” approach was used for nerve block and radiofrequency puncture. Results: After the “three-in-one” approach, the 8 patients showed varying degrees of improvement in their Numeric Rating Scale (NRS) scores. The patients were satisfied with the treatment method and efficacy, and no complications, such as nerve damage, occurred during the operation. Conclusion: The “three-in-one” approach is a potentially effective method for treating pain in the inner lower limb area, significantly reducing the damage caused by multiple puncture and providing ideas for more minimally invasive treatment of other areas; this approach meets expectations for more minimally invasive treatment. Plain Language Summary: With the continuous development of society and the increasing demand of patients for more comfortable treatment experience, minimally invasive puncture technology has become a direction pursued by more and more pain specialists. Our proposed “three-in-one” puncture technique is suitable for patients with lower limb medial pain. There is only one puncture point on the skin, and by adjusting the puncture direction, the surgeon can simultaneously block three nerves (the cutaneous branch of the obturator nerve, the anterior branch of medial femoral cutaneous nerve, and the infrapatellar branch of the saphenous nerve). This technology can also be used for pain treatment or auxiliary anesthesia in the inner thigh area. We also hope that our innovation can promote the development of more minimally invasive puncture technologies. Keywords: neuropathic pain, minimally invasive surgery, puncture technique, nerve block

Source: Local and Regional Anesthesia

DOI: 10.2147/lra.s511488

Authors: Jinyu Lai, Yan Lai, Yijun Wu, Yong Xiang, Fengqin Zhang

Institutions: Hubei University of Medicine, Taihe Hospital

Language: English

Topic: Pain Management and Treatment

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,320