Anesthesia Dolorosa - Causes and Management

Introduction

Anesthesia blocks the pain signals going to the brain from its applied site. It is usually used in surgeries to control pain during or after surgery. However, sometimes after the surgery, these anesthetic injection sites can be painful; that is called anesthesia dolorosa. This topic presents anesthesia dolorosa with its causes, symptoms, and treatment.

What Is Anesthesia Dolorosa?

Anesthesia Dolorosa is severe spontaneous pain occurring in the area where anesthetic agents are delivered. It usually happens in facial areas after trigeminal neuralgia treatment. As treatment has affected the trigeminal nerve. Anesthesia Dolorosa means painful numbness. It is a pain in the area that is entirely numb to touch. The area, along with numbness, has a loss of sensation in the part of the body. It is a type of side effect of surgery that involves anesthesia.

How Do Anesthesia Dolorosa Patients Feel Pain?

Anesthesia Dolorosa patients have very severe pain. The pain is described as constant, burning, aching, squeezing, heaviness, tightness, and pressured or piercing pins. Initially, the pain is persistent, but further, the patient can have a brief burst of pain. Anesthesia Dolorosa is not diagnosed on a pain basis; other symptoms, along with pain symptoms, complete the anesthesia Dolorosa diagnosis.

What Are the Causes of Anesthesia Dolorosa?

Although the cause of anesthesia dolorosa has been unknown, still the causes of anesthesia dolorosa have been stated by several theories. Some of the ideas are listed below:

1. The first theory states that nerve fibers carrying touch sensation are injured during surgery while no damage or injury is involved in the fibers having pain.

2. The second theory depicts that surgical injury can prevent nerve fibers from overlapping, leading to distorted nerve signals sent to the brain.

3. And the third theory says after the surgery, the brain can get confused with the sudden absence of pain signals from the area, leading to remembering or relaying old pain signals.

How Is Anesthesia Dolorosa Associated With Trigeminal Neuralgia?

Trigeminal neuralgia is a chronic pain condition that causes sudden, intense pain episodes on one side of the face. There are many treatments for trigeminal neuralgia, but most treatment plans involve anesthetic agents. Sometimes, treatment of trigeminal neuralgia can cause side effects. Anesthesia Dolorosa is the side effect of trigeminal neuralgia. Anesthesia dolorosa is related to trigeminal nerve injury that causes severe pain after the trigeminal neuralgia treatment.

What Are the Symptoms of Anesthesia Dolorosa?

Symptoms of anesthesia dolorosa are:

• Severe continuous pain.
• Numbness in the area.
• Loss of sensation.
• The entire affected face may be hot or cold.
• The patient is unable to even touch the side of the face that is affected.

What Is the Treatment of the Anesthesia Dolorosa?

Treatment of anesthesia dolorosa involves both medicinal approaches and other complementary approaches. The treatment is by:

1. Medication Approach - It is included in the treatment and involves the medicine that eases the patient and heals the pain.

• Muscle relaxants.
• Antidepressants.
• Topical use of anesthetics like a eutectic mixture of local anesthesia (EMLA).
• Anticonvulsants.
• Topical ointments.
• Injections of Lidocaine and opioid anesthetic agents over the targeted site.
• Oral morphine drugs like Oxycontin.

2. Complementary Approach - Complementary approach is the approach along with the medication to improve the patient's pain status and inhibit the anesthesia dolorosa.

• Acupuncture - Acupuncture involves the insertion of skinny needles through the skin at different locations to control the symptoms and heal the patient's suffering.
• Upper Cervical Chiropractic - Upper cervical chiropractic focuses mainly on correcting misaligned upper neck and spine, but it can also be used to heal pain.
• Nutrition Therapy - Nutrition or diet has a significant role in nutritional medicine. It involves a diet that approaches maximizing the patient's health potential and inhibits disease or suffering.
• Hot and Cold Compress Therapy - Hot and cold compression relieves the patient's pain. It is often recommended to alleviate the aching pain. Heat therapy uses hot water bottle pads, and cold therapy uses cold water pads; alternating hot and cold therapy increases the blood flow to the injured site.
• Biofeedback - The process by which the patient learns to manipulate the body system. It improves physical and mental health.
• Mechanical Stimulation - Treatment like transcutaneous electrical nerve stimulation (TENS) comes under it. It is the therapy used to treat acute and chronic pain conditions.
• Medical Treatment - Any surgical procedure may be used to manage the anesthesia dolorosa.
• Anesthetic Injections - Nerve blocks can be used to control the pain by injecting the injection into the trigeminal nerve.
• DREZ Procedure - The dorsal root entry zone (DREZ) is the treatment for severe pain used in the spinal cord region.
• Motor Cortex Stimulation - It uses an implanted electrode that provides constant stimulation.

How Common Is Anesthesia Dolorosa Condition After Trigeminal Treatment?

Anesthesia Dolorosa is an uncommon condition that very occasionally affects thousands of sufferers. The treatment used in conjunction with an anesthetic to treat trigeminal neuralgia or other areas typically produces positive results with few adverse effects. As a result, anesthesia dolorosa does not arise soon.

Can Anesthesia Dolorosa Be Healed by Treatment?

No, the complete cure of anesthesia dolorosa is not present till now. However, the treatment approaches mentioned in the topic have many favorable effects on the patient to relieve the symptoms and free the patient from pain and suffering.

Can Anesthesia Dolorosa Cause Difficulty in Chewing?

Yes, it can cause difficulty in chewing also. The symptom may or may not be present in the patient with anesthesia dolorosa. As the pain is continuous, the patient feels uneasy eating and chewing while bearing the severe constant pain.

Conclusion

Anesthesia Dolorosa is a severely painful condition that occurs as a side effect of treatment. It is mainly associated with trigeminal neuralgia. After treating trigeminal neuralgia, very rarely patients can face an anesthesia dolorosa problem. It involves symptoms like loss of sensation, continuous pain over the affected face or other areas, and numbness and the patient feels pain on touching the face. Medication approaches like using muscle relaxants or complementary approaches like using acupuncture and biofeedback are the different methods to treat anesthesia dolorosa.