Meralgia parestésica / Meralgia paresthetica

RESUMEN Fundamento: la meralgia parestésica es una mononeuropatía por atrapamiento que genera dolor, parestesias y pérdida de la sensibilidad en el territorio del nervio cutáneo lateral del muslo. Objetivo: profundizar y actualizar los aspectos más importantes de la meralgia parestésica. Métodos: se realizó una revisión de la literatura en idioma español e inglés disponible en PubMed Central, Hinari y SciELO. Para ello se utilizaron los siguientes descriptores: meralgia paresthetica, mononeuropathy, lateral cutaneous nerve of the thigh. A partir de la información obtenida se realizó una revisión bibliográfica de un total de 107 artículos publicados, incluídas 34 citas seleccionadas para realizar la revisión, de ellas 24 de los últimos cinco años. Desarrollo: se insistió en aquellos tópicos controversiales dentro del tema como son: reseña anatómica, factores etiológicos, presentación clínica, estudios complementarios y tratamiento. Conclusiones: la meralgia parestésica es un reto médico, debido a que puede simular enfermedades comunes como los desordenes lumbares. Es una enfermedad autolimitada cuyo diagnóstico se realiza con un alto índice de sospecha basado en el conocimiento adecuado de la anatomía, la fisiopatología, los factores etiológicos y los elementos clínicos. El tratamiento, aunque con falta de consenso, ofrece resultados favorables en la mayoría de los pacientes.

ABSTRACT Background: meralgia paresthetica is an entrapment mononeuropathy which cause pain, paresthesias and sensory loss within the distribution of the lateral cutaneous nerve of the thigh. Objective: to update and to deepen in the most important aspects of meralgia paresthetica. Methods: a revision of the literature was made in English and Spanish, available in PubMed Central, Hinari and SciELO. The following descriptors were used: meralgia paresthetica, mononeuropathy, lateral cutaneous nerve of the thigh. Base on the obtained data, a bibliographic revision was made of 107 published articles, including 34 cites selected for the research, 24 of them of the last five years. Development: it was focus in those controversial topics like: anatomic characteristics, etiological factors, clinical presentation, complementary studies and treatment. Conclusions: meralgia paresthetica is a medical challenge; due to it can simulate common illness like lumbar disorders. It is a self limited disease which is diagnosed basing on a high suspicious index with an adequate knowledge of the anatomy, physiopathology, etiological factors and clinical elements. The treatment, although with lack of consensus, offers favorable results in most of the patients.

Clinical study for skin graft donor site after regional thigh blockade

In general, split thickness skin graft was done under general anesthesia. However, there was a difficulty to do general anesthesia in some cases due to poor general condition. The lateral cutaneous nerve block of the thigh(LCNBT) anesthesia the usual donor site of split-thickness skin graft in the thigh. Using 10 ml of 0.5% bupivacaine, LCNBT was used thigh for harvesting split-thickness skin in 42 patients. Patients age ranged from 18 to 62 years with mean 49 years. The onset of full anesthesia took between 12 and 21 minutes. The area anesthetised ranged from 200 cm2to 940 cm2with mean 551 cm2. The duration of full anesthesia was from 6 to 16 hours. In 6 patients, LCNBT was compared with previous lidocaine local anesthesia and all patients preferred to do LCNBT. In our experience, LCNBT is a safe, and simple method for harvesting split-thickness from the thigh and LCNBT provided good postoperative analgesia.