Meralgia Paraesthetica after Prone Position Ventilation in a Patient with COVID-19

Background and objectives: One of the most feared complications of COVID-19 is respiratory failure caused by acute respiratory distress syndrome. In order to improve oxygenation and survival, patients admitted to intensive care units and intubated may undergo prone position mechanical ventilation. Prolonged prone positioning may cause meralgia paraesthetica due to lateral femoral cutaneous nerve entrapment between the inguinal ligament and the anterior superior iliac spine. Reports of the first two cases have been recently published. Case presentation: We describe the case of a 52-year-old man with respiratory failure during COVID-19 infection, who underwent prone position ventilation for 16 hours a day over 19 days and developed persistent burning pain and dysaesthesia on the lateral surface of the thigh bilaterally, diagnosed as meralgia paraesthetica. Conclusion: This is the second report describing meralgia paraesthetica following prone position ventilation in COVID-19. Given the ongoing pandemic and the inevitability of more patients with severe respiratory distress requiring prone position ventilation, this disabling entrapment condition should be considered and possibly prevented.

Meralgia paraesthetica treatment with pulsed radiofrequency

Una paciente desarrolló tras someterse a cirugía de raquis, dolor en muslo izquierdo de características compatibles con meralgia parestésica, sin obtener respuesta al tratamiento médico. Se infiltró el nervio femorocutáneo lateral con mejoría temporal de la sintomatología, por lo que se decidió́ realizar ablación del mismo mediante radiofrecuencia pulsada, tras la cual el dolor cedió de forma inmediata. A los 6 meses postintervención, la paciente refiere leves molestias, habiendo recuperado prácticamente toda actividad previa.

Aetiology of Neuropathic Pain (NP) Along with Role of Gabapentinoids Like Pregabalin and Gabapentin in Treating the Excruciating Pain Besides Other Newer Alternatives-a Systematic Review

Neuropathic pain (NP) by definition is a problem that involves the somatosensory system either as a manifestation as disease or as a lesion. Lot of differing causes either of central/peripheral origin can stimulate NP and that might affect life’s quality badly. Worldwide prevalence of NP varies from 6.9-10% with spinal cord injury (SCI) explaining 40% of them. The 2nd commonest cause is diabetic peripheral neuropathy (DPN) that accounts for 22-28% of type 2 diabetes mellitus (T2DM). After having reviewed thoroughly how to manage diabetic neuropathic pain here we decided to conduct a systematic review on varying causes of NP and the role of gabapentenoids in managing the excruciating pain. Besides newer opioid analogues not having addictive potential like fentanyl matrix with its availability in intradermal formulations, delta opioid receptor agonist BBI-11008, an innovative analog N-(1-benzylpiperidin-4-yl)-4-fluorobenzamide (LMH2), that is like haloperidol, along with advantages of Gabapentin-ER as well as therapy of trigeminal neuralgia with anticonvulsants like carbamazepine and use in Immunotherapy utilizing 14,18 anti GD2 antibody (ch14.18) associated excruciating pain and in Meralgia paraesthetica (MP) is discussed besides alternative therapies when gabapentenoids fail.

Entrapment syndromes

Peripheral nerve entrapment is common. Patients present with tingling and pain in the distribution of the affected nerve. This will progress to altered sensation and weakness with prolonged and/or increasing pressure. The most common nerve entrapment syndromes are carpal tunnel affecting the median nerve at the wrist and cubital tunnel affecting the ulnar nerve at the elbow. They affect the working population, so time-efficient diagnosis and robust effective treatment strategies are important to minimize the financial implications to industry. Aetiology, diagnosis, and management strategies for carpal tunnel, cubital tunnel, and meralgia paraesthetica are discussed in this chapter along with a brief overview of other entrapment syndromes. Current controversies between open and endoscopic carpal tunnel release are also reviewed.

Effectiveness of tendoachilles and hamstring stretching on nocturnal leg cramps among antenatal women

Pregnancy also known as gravidity, is the duration which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. In the pregnancy which lasts about 40 weeks, is grouped into three trimesters. Maternal physiologic adaptations are attributed to the hormones of pregnancy and to mechanical pressures arising from the enlarging uterus and other tissues. These adaptations protect the woman’s normal physiologic functioning, meet the metabolic demands pregnancy imposes on her body, and provide a nurturing environment for foetal development and growth. Although pregnancy is a normal phenomenon, problems can occur. The hormonal and physical changes of pregnancy result in enormous changes in a woman’s body. Enormous amount of estrogen is produced which leads to the discomforts during pregnancy. Common musculoskeletal discomforts are back pain, sacroiliac joint dysfunction, leg cramps, nerve compression syndromes like carpel tunnel syndrome, brachial plexus pain, meralgia paraesthetica, posterior tibial nerve compression, circulatory disorder such as varicose vein in the legs, vulval varicose vein, haemorrhoids, cramp, thrombosis and thrombo embolism, thoracic outlet syndrome, thoracic spine pain, postural back ache, osteoporosis of pregnancy, fatigue, insomnia and nightmares.