INTEGRATED THERAPY BETWEEN ELECTRO-ACUPUNCTURE AND IMPAR GANGLION BLOCKADE FOR THE TREATMENT OF PERSISTENT POSTOPERATIVE PAIN AFTER RADICAL PROSTATECTOMY: PRELIMINARY DATA

G. Gagliardi^1,3, V. Gagliardi^2,3, A. Lovato³, F. Ceccherelli³, S. Pellielo^2,3 | ¹Dept. of Anesthesia and Resuscitation, “Santa Maria della Misericordia” Hospital, Ulss 5 Polesana, Rovigo; ²Dept. of Anesthesia and Resuscitation “Ospedale dell’Angelo”, Ulss 3 Serenissima, Mestre (VE); ³A.I.R.A.S. Padova - Italian Association for Scientific Research and Updating, Lonigo (VI)

According to the ICD-11, chronic postoperative pain is defined as chronic pain that develops or increases in intensity after surgery or tissue injury, and persists beyond the healing process (i.e. for at least three months after surgery or tissue injury). It is reported that the incidence of chronic pain after radical prostatectomy is around 20% of cases, often in combination with urination disorders. The symptoms' aetiology is multifactorial, involving a combination of neurological, endocrine-immunological, and psychological factors^1,2. The initial trigger (e.g. infection or surgical trauma) often leads to the persistence of an inflammatory state and/or neurogenic damage, which can progress to chronic pain. Therapeutic strategies for pain treatment essentially involve the use of analgesic drugs (NSAIDs and opiates), SSRIs, and gabapentinoids³. To improve the long-term efficacy of symptom treatment, the current recommendation is to adopt an integrated approach combining pharmacological and non-pharmacological techniques³. The current recommendation to improve long-term symptom treatment effectiveness is to employ an integrated therapy combining pharmacological and non-pharmacological techniques^3,4. This study aims to evaluate the efficacy of combining electro-acupuncture, impar ganglion blockade and pharmacological treatment for chronic post-operative pain following radical prostatectomy. To date, ten patients with a mean age of 71 ± 8.06 and a mean pain duration of 15 ± 5.2 months have been treated. Their current pharmacological treatment was insufficient for adequate pain control. The patients underwent eight weekly electro-acupuncture sessions targeting the BL30 and BL35 points, combined with impar ganglion blockade using 10 ml of 0.5% levobupivacaine. The treatment was effective in reducing pain intensity for up to three months after treatment.