NEURECTOMY PROCEDURE IN ANESTHESIA: "Neurectomy: Surgical Procedure for Chronic Pain Relief, Types, Risks, Effectiveness, and Recovery"

DEFINITION 

   A neurectomy is the surgical removal or severing of part or all of a nerve. It is often used as part of the treatment to ease chronic pain or with a medical condition that involves the dysfunction of a particular nerve.

 

Reason for Neurectomy

The primary purpose of a neurectomy is to alleviate or remove chronic pain or symptoms related to nerve disorders. Common conditions treated with a neurectomy are:

Chronic pain due to injury or trauma.

Trigeminal neuralgia resulting in facial pain.

Neuralgia or nerve pain on the chest wall.

Neuroma of Morton's or nerve pain on the foot.

 Types of Neurectomy

Neurectomies are further subdivided based on the site and intent of surgery:

Peripheral Neurectomy: 

The surgical resection of peripheral nerves, for example, in limbs or face.

Spinal Neurectomy : 

The goal is to address nerves of the spinal column to ensure relief of back or other symptoms associated with pain.

Sympathetic Neurectomy: It targets the sympathetic nervous system for the management of hyperhidrosis (excessive sweating), among many others, or Raynaud's disease.

Surgery

Neurectomy basically comprises the following steps in the surgery:

Pre surgical Imaging: 

Most of the time, MRI or CT scans are essential to determine the offending nerve.

Surgical access: 

The surgeon makes a cut to get to the offending nerve.

Cutting or elimination of the nerve: 

In this procedure, the offending nerve is either cut or entirely removed.

For the patient to walk out of the hospital after the operation, there must be a physician's prescription for physical therapy, management of pain, and serial examinations.

Complications and Risks

Neurectomy, as any surgical intervention, has attendant risks, which are many, such as:

Numbness or Tingling: 

Permanent numbness over the area served by the severed nerve.

Infection or Bleeding: 

Just like any other surgical procedure.

Recurrence of Pain: 

The pain may recur after the surgery in some cases.

Efficacy

Neurectomy can be useful in the treatment of pain, but it all depends on the actual condition of the patient and their reaction to treatment.

Some of the patients progress towards long-term relief, while others get further treatments.

Alternatives

Neurectomy is typically not considered unless medication and possibly physical therapy or nerve blocks are firstly tried. However, if pain relief cannot be found through those means, this might be the option.

Recovery Time

By the nature of neurectomy, though there is difference, generally a few weeks would suffice in taking the patient to his normal activities. However, for full recovery, physical therapy might be prescribed.

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