ABSTRACT
Postsurgical persistent pain, once entrenched, may be resistant to western medical treatments. A 39-year-old man who underwent thoracic repair with blood vessel prosthesis for dissecting aneurysm was presented to our pain clinic due to postoperative persistent pain. He complained his pain mainly around the sternum on which skin became keloid scar and presented tactile allodynia. Initially, we treated the patient with pregabalin, duloxetine and tramadol/acetaminophen fixed-dose combination tablets, leading to no pain relief. Then, we started the treatments with Kampo medicine as well as Yamamoto New Scalp Acupuncture and Unblocking acupuncture. We initially treated him with keishibukuryogan (TJ-23 ; Tsumura ®, Japan) and saikokeishito (TJ-10 ;Tsumura ®, Japan) based on the signs of blood stasis, hypochondrial resistance and pain, but no relief of pain was obtained. Thus, we administered ogikeishigomotsuto in addition to the above Kampo formulas. His pain was gradually decreased with increasing doses of ogi from 3 to 10 g/day and aconite tuber from 1.5 to 6 g/day due to cold sensation, and finally disappeared at 20 months since the start of Kampo treatments. The duration of effectiveness for relieving his pain with acupuncture was gradually increased in proportion to his pain relief. Our experiences suggest that ogikeishigomotsuto with aconite tuber as well as acupuncture may be optimal treatments for the patients with cold sensation suffering from postsurgical persistent pain.