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Master Thesis

Neurolyse alcoolique sciatique pour Ischemie Critique Chronique des membres inferieurs : impact sur la qualité de vie des patients ; étude rétrospective en LISP de janvier 2017 à avril 2019

Abstract : Introduction: patients with critical limb ischemia do not always benefit from a specific vascular approach, often leaving amputation or a conservative treatment as the only remaining solutions, which are limited in terms of pain relief and side effects. In such cases, the palliative approach is necessary. The aim of this study is to assess the impact of sciatic nerve neurolysis, on the quality of life, as well as to understand the process that leads to this decision. Method: this work is a descriptive, retrospective study, based on medical files from 13 patients hospitalized in the palliative care unit from MSPB, between 2017 and 2019. The main hypothesis is that through this intervention, pain management is achieved, allowing patients to return home, and may result in improved quality of life. Results: in patients who returned home (a majority, 61.5%), a significant analgesic effect resulted between pain intensity at the beginning, and end of the hospitalization. The median value of survival, after the intervention, was 41 days, with two patients re-admitted, one for a nerve regeneration. Five patients did not return home, and died after a median length of 7 days, post-neurolysis. Additional neurolysis was occasionally required when pain occurred in a different nerve segment. Each care plan was a collaborative effort, facilitating a multidisciplinary effort for most patients. The decision was driven by the goal of a long-term pain relief, a way to return home, amputation-avoidance, and pre-existing limb function limitation. Discussion: this study suggests that neurolysis may improve the patient’s quality of life. However, limitations remain regarding the study design, and for alcoholic neurolysis itself; thus further is necessary. This method should only be considered after strict examination, through multidisciplinary collaboration.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02492114
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, February 26, 2020 - 4:30:50 PM
Last modification on : Thursday, March 5, 2020 - 1:20:47 AM
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Alex Chanteclair. Neurolyse alcoolique sciatique pour Ischemie Critique Chronique des membres inferieurs : impact sur la qualité de vie des patients ; étude rétrospective en LISP de janvier 2017 à avril 2019. Médecine humaine et pathologie. 2019. ⟨dumas-02492114⟩

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