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<p>Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms</p>

2020; Dove Medical Press; Volume: Volume 13; Linguagem: Inglês

10.2147/jpr.s247208

1178-7090

King Hei Stanley Lam, Chen‐Yu Hung, Yi‐Pin Chiang, Kentaro Onishi, Daniel Su, Thomas B. Clark, Kenneth Dean Reeves,

Botulinum Toxin and Related Neurological Disorders

Abstract: Nerve hydrodissection (HD), a technique used when treating nerve entrapments, involves the injection of an anesthetic, saline, or 5% dextrose in water to separate the nerve from the surrounding tissue, fascia, or adjacent structures. Animal models suggest the potential for minimal compression to initiate and perpetuate neuropathic pain. Mechanical benefits of HD may relate to release of nervi nervorum or vasa nervorum compression. Pathologic nerves can be identified by examination or ultrasound visualization. The in-plane technique is the predominant and safest method for nerve HD. Five percent dextrose may be favored as the preferred injectate based on preliminary comparative-injectate literature, but additional research is critical. Literature-based hypotheses for a direct ameliorative effect of dextrose HD on neuropathic pain are presented. Keywords: nerve hydrodissection, pain management, ultrasonography, neuropathic pain