Smith Howard S, Pilitsis Julie G
1Department of Anesthesiology, Albany Medical College, Albany, NY, USA.
Am J Hosp Palliat Care. 2014 Mar;31(2):211-9. doi: 10.1177/1049909113482745. Epub 2013 Mar 26.
The palliative care population is generally vulnerable to experiencing medication-induced adverse effects and drug-drug interactions. Neuromodulation may offer particular advantages over systemic medications in this population. Spinal cord stimulation and peripheral nerve stimulation have long been utilized in efforts to provide analgesia for various painful conditions. More recently, deep brain stimulation/motor cortex stimulation has anecdotally been utilized for certain intractable pain states. Although brain electrical stimulation has not been adequately trialed or in some cases even tried at all for management of a variety of symptoms, it is conceivable that in the future it may be a potential therapeutic option in efforts to palliate various severe refractory symptoms (eg, intractable pain, nausea, dyspnea, delirium).
姑息治疗人群通常容易出现药物引起的不良反应和药物相互作用。在这一人群中，神经调节可能比全身用药具有特殊优势。脊髓刺激和外周神经刺激长期以来一直被用于为各种疼痛状况提供镇痛。最近，深部脑刺激/运动皮层刺激已被用于某些难治性疼痛状态。尽管脑电刺激尚未针对各种症状的管理进行充分试验，甚至在某些情况下根本未进行尝试，但可以想象，未来它可能成为缓解各种严重难治性症状（如难治性疼痛、恶心、呼吸困难、谵妄）的一种潜在治疗选择。
