Immediate Past President Pain SA, South African Society of Anaesthesiologists.
S Afr Med J. 2013 Mar 26;103(6 Pt 2):423-30. doi: 10.7196/samj.6323.
Spinal cord stimulation (SCS) is an accepted method of pain control. SCS has been used for many years and is supported by a substantial evidence base. A multidisciplinary consensus group has been convened to create a guideline for the implementation and execution of an SCS programme for South Africa (SA). This article discusses the evidence and appropriate context of SCS delivery, and makes recommendations for patient selection and appropriate use. The consensus group has also described the possible complications following SCS. This guideline includes a literature review and a summary of controlled clinical trials of SCS. The group notes that, in SA, SCS is performed mainly for painful neuropathies, failed back surgery, and chronic regional pain syndrome. It was noted that SCS is used to treat other conditions such as angina pectoris and ischaemic conditions, which have therefore been included in this guideline. These recommendations give guidance to practitioners delivering this treatment, to those who may wish to refer patients for SCS, and to those who care for patients with stimulators in situ. The recommendations also provide a resource for organisations that fund SCS. This guideline has drawn on the guidelines recently published by the British Pain Society, and parts of which have been reproduced with the society's permission. These recommendations have been produced by a consensus group of relevant healthcare professionals. Opinion from outside the consensus group has been incorporated through consultation with representatives of all groups for whom these recommendations have relevance. The recommendations refer to the current body of evidence relating to SCS. The consensus group wishes to acknowledge and thank the task team of the British Pain Society for their help and input into this document.
脊髓刺激 (SCS) 是一种公认的疼痛控制方法。SCS 已经使用了多年，并得到了大量证据的支持。一个多学科共识小组已经成立，为南非 (SA) 制定 SCS 计划的实施和执行指南。本文讨论了 SCS 传递的证据和适当背景，并对患者选择和适当使用提出了建议。共识小组还描述了 SCS 后可能出现的并发症。本指南包括对 SCS 的文献回顾和对照临床试验总结。该小组指出，在南非，SCS 主要用于治疗疼痛性神经病变、失败的背部手术和慢性区域性疼痛综合征。还注意到 SCS 用于治疗心绞痛和缺血性疾病等其他病症，因此已将这些病症纳入本指南。这些建议为提供这种治疗的医生、可能希望为 SCS 患者转诊的医生以及为体内有刺激器的患者提供护理的医生提供了指导。该建议还为资助 SCS 的组织提供了资源。本指南借鉴了英国疼痛学会最近发布的指南，其中部分内容经学会许可转载。这些建议是由相关医疗保健专业人员的共识小组制定的。通过与所有相关群体的代表协商，纳入了来自共识小组之外的意见。这些建议涉及与 SCS 相关的现有证据。共识小组希望感谢英国疼痛学会的任务小组在本文件中的帮助和投入。
