Pain Therapy Unit Cardarelli Hospital, Naples, Italy.
Neuromodulation. 2011 Mar-Apr;14(2):146-9; discussion 149-50. doi: 10.1111/j.1525-1403.2010.00323.x. Epub 2011 Jan 10.
Abdominal angina occurs in patients affected by mesenteric artery obstruction, causing postprandial episodes of visceral pain. The conventional treatment consists of vessels revascularization, but sometimes this is not applicable.
The authors report a case of a patient with severe abdominal angina caused by mesenteric ischemia, not treatable with surgery and few-responder to pharmacological therapy (opioids and epidural infusion of local anesthetics). After a successful screening test, the patient underwent implantation of a spinal cord stimulation (SCS) device.
The stimulation provided a reduction in pain episodes (number and intensity) and in oral analgesics consumption. Results obtained support the clinical efficacy and durability of the SCS in the management of abdominal angina due to not treatable mesenteric ischemia.
Spinal cord stimulation may be considered for abdominal angina, although there is still no evidence provided by controlled studies.
肠系膜动脉阻塞可导致餐后内脏疼痛发作,即腹痛。常规治疗为血管再通,但有时不适用。
作者报告了一例肠系膜缺血引起的严重腹痛患者,手术治疗无效,对药物治疗(阿片类药物和硬膜外局部麻醉剂输注)反应不佳。在成功进行筛选试验后,患者接受了脊髓刺激(SCS)装置植入。
刺激治疗减少了疼痛发作的次数和强度,同时降低了口服镇痛药的用量。获得的结果支持 SCS 在治疗因不可治疗的肠系膜缺血引起的腹痛方面的临床疗效和耐用性。
尽管对照研究尚无证据,但仍可考虑将脊髓刺激用于治疗腹痛。