Tulgar M
Division of Functional Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Adv Ther. 1992 Nov-Dec;9(6):366-72.
Pharmacologic treatments to manage chronic intractable pain have long been sought. Neuropathic pain is usually resistant to analgesics. At present, no analgesic drug totally relieves pain without producing significant unwanted side effects. Electrical stimulation can offer a degree of relief to some sufferers without risk. Transcutaneous electrical nerve stimulation (TENS) has a long clinical history. Stimulation parameters have been studied to improve the efficacy of this method. TENS is inadequate for extensive and bilateral pain, and epidural spinal cord stimulation is indicated. Dorsal column stimulation (DCS) initially was used to manage pain, but recent clinical reports show that it also can be effective in vascular disease and movement disorders. This review article reports on improvements in the electrical parameters used in neurostimulation and advances in research to overcome methodologic problems of DCS.
长期以来，人们一直在寻找治疗慢性顽固性疼痛的药物疗法。神经性疼痛通常对镇痛药有抗性。目前，没有一种镇痛药能在不产生明显不良副作用的情况下完全缓解疼痛。电刺激可以为一些患者提供一定程度的缓解且无风险。经皮电刺激神经疗法（TENS）有着悠久的临床历史。人们已经对刺激参数进行了研究，以提高这种方法的疗效。TENS对于广泛的双侧疼痛效果不佳，此时应采用硬膜外脊髓刺激。背柱刺激（DCS）最初用于治疗疼痛，但最近的临床报告表明，它在血管疾病和运动障碍方面也可能有效。这篇综述文章报道了神经刺激中使用的电参数的改进以及为克服DCS方法学问题所取得的研究进展。
