PDF(Pubmed)
Abstract：
Chronic pain is a complex condition that often poses diagnostic and management challenges due to its multifactorial etiology. This case report describes a 49-year-old pastor who presented with a three-year history of chronic pain affecting multiple sites, including the neck, bilateral shoulders, thoracic region, lower back, and bilateral knees. Additionally, he experienced shortness of breath on mild exertion, which adversely affected his ability to converse and speak publicly. The patient had a rapid resting heart rate of 100-120 beats per minute, occasional palpitations, and a 24-hour electrocardiogram that confirmed 15% premature ventricular complexes with bigeminy and trigeminy. He complained of limited appetite with early satiety, intermittent nausea, and regurgitation. Despite consultations with multiple specialists, no underlying causes were identified in the cardiac, respiratory, gastrointestinal, or psychological domains. Ultrasound-guided bilateral vagus nerve hydrodissection using 5% dextrose without local anesthetics was administered three times at monthly intervals, resulting in remarkable pain relief within three months and the effects persisted at the nine-month follow-up. Tachycardia was no longer perceived, resting heart rate slowed to 70-80 beats per minute, shortness of breath improved, and public speaking ability was restored. The patient\'s early satiety, nausea, and reflux complaints were resolved. This case report highlights the potential effectiveness of this novel intervention for chronic pain. Further research is warranted to validate these findings and explore the mechanism of action.
摘要：
慢性疼痛是一种复杂的疾病，由于其多因素病因，通常会带来诊断和管理方面的挑战。该病例报告描述了一名49岁的牧师，他有三年的慢性疼痛病史，影响多个部位。包括脖子,双边肩,胸部区域,下背部,双侧膝盖。此外,他轻度劳累时呼吸急促，这对他公开交谈和讲话的能力产生了不利影响。患者的静息心率为每分钟100-120次，偶尔心悸,和24小时心电图证实15%室性早搏与双联和三联。他抱怨食欲有限，饱腹感早熟，间歇性恶心,和反流。尽管咨询了多位专家,在心脏中没有发现潜在的原因，呼吸,胃肠,或心理领域。超声引导下使用5%葡萄糖无局部麻醉药的双侧迷走神经水切开术，每个月给药3次，在3个月内显著缓解疼痛，在9个月随访时效果持续。不再感觉到心动过速，静息心率减慢到每分钟70-80次,改善呼吸急促,公众演讲能力得到恢复。病人的早期饱腹感，恶心,反流投诉得到解决。该病例报告强调了这种新型干预治疗慢性疼痛的潜在有效性。需要进一步的研究来验证这些发现并探索作用机制。
