# A rare case of perineal neuralgia treated with ultrasound‐guided nerve block combined with water separation

## TL;DR

A man with persistent nerve pain after hernia surgery found relief through ultrasound-guided nerve blocks and water separation, showing this method can effectively treat post-surgical neuralgia.

## Contribution

Demonstrates the effectiveness of combining ultrasound-guided nerve block with water separation for treating post-surgical neuralgia.

## Key findings

- VAS score dropped from 7 to 1 after five treatments and remained at 0 for six months.
- Ultrasound-guided nerve block combined with water separation effectively alleviated pain caused by surgical adhesion.
- The treatment method shows important clinical significance for managing post-surgical neuralgia.

## Abstract

A middle‐aged man experienced intermittent acupuncture‐like pain in the skin of the right scrotum and medial thigh 1 month after undergoing laparoscopic high ligation of the right hernial sac for a right indirect inguinal hernia in November 2020, and the pain persisted for 6 months. Under ultrasound guidance, ilioinguinal and genitofemoral nerve block and local adhesion water separation were performed with a mixture of 0.25% lidocaine (6 mL) plus prednisolone acetate (10 mg), and the same drugs and methods were repeated five times once a week. After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. During the follow‐up period, at 3 months after the end of treatment, the VAS score remained at 0, and this score was sustained at 0 even at the 6‐month follow‐up. These outcomes indicate that ultrasound‐guided nerve block combined with water separation technology can effectively alleviate neuralgia caused by surgical adhesion, which holds important clinical significance in managing such conditions.

A middle‐aged man presented with a right indirect inguinal hernia in November 2020 and underwent laparoscopic high ligation of the right hernial sac. Intermittent acupuncture‐like pain in the skin of the right scrotum and medial thigh occurred 1 month after surgery and lasted for 6 months. Under ultrasound guidance, ilioinguinal nerve and genitofemoral nerve block and local adhesion water separation were performed with 0.25% lidocaine 6 mL plus prednisolone acetate 10 mg mixture, and the same drugs and methods were used for five treatments (once a week). After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. The VAS score of the follow‐up patients was 0 at 3 months after the end of treatment, and the VAS score of the follow‐up patients was still 0 at half a year. It can be seen that ultrasound‐guided nerve block combined with water separation technology can be used for neuralgia caused by surgical adhesion, which has important clinical significance.