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经皮电场刺激神经调节与阿片类药物戒断症状和体征的减轻相关:一项多中心回顾性评估。

Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment.

作者信息

Miranda Adrian, Taca Arturo

机构信息

a Department of Pediatrics, Division of Gastroenterology and Hepatology , Medical College of Wisconsin , Milwaukee , WI , USA.

b St. Louis University School of Medicine , St. Louis , MO , USA.

出版信息

Am J Drug Alcohol Abuse. 2018;44(1):56-63. doi: 10.1080/00952990.2017.1295459. Epub 2017 Mar 16.

Abstract

BACKGROUND

Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain.

OBJECTIVES

This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT).

METHODS

Adult patients treated with the BRIDGE during medically supervised withdrawal were included in this open label, uncontrolled, and retrospective study. The clinical opioid withdrawal scale (COWS) scores were prospectively recorded at different intervals (20, 30, and 60 min) and analyzed retrospectively. A subset of patients had scores recorded 5-days post-BRIDGE. Those who returned to the clinic and received their first dose of maintenance medication were considered to be successfully transitioned.

RESULTS

In this cohort (n=73), 65% were male. The mean COWS score prior to BRIDGE placement was 20.1 (±6.1). Twenty minutes after BRIDGE placement, the mean score was reduced to 7.5 (±5.9) (62.7% reduction, p<0.001). The scores further decreased after 30 minutes 4.0 (±4.4) and 60 minutes 3.1 (±3.4) (84.6% reduction, p<0.001). No rescue medications were administered during this period. The mean withdrawal score on day 5 was 0.6 (97.1% reduction, p<0.001) (n=33). Overall, 64/73 patients (88.8%) successfully transitioned to MAT.

CONCLUSIONS

Neurostimulation with the BRIDGE is associated with a reduction in opioid withdrawal scores. This effect persisted during the induction period and allowed for effective transition to MAT.

摘要

背景

找到一种有效的非药物方法来治疗阿片类药物戒断反应,可能会消除一些与药物治疗相关的障碍。BRIDGE®是一种开发用于治疗疼痛的非侵入性经皮电场刺激器。

目的

这项初步研究旨在确定(1)BRIDGE对阿片类药物戒断治疗诱导期戒断评分的影响,(2)成功过渡到药物辅助治疗(MAT)的受试者百分比。

方法

本开放标签、非对照回顾性研究纳入了在医学监督下戒断期间接受BRIDGE治疗的成年患者。前瞻性记录不同时间间隔(20、30和60分钟)的临床阿片类药物戒断量表(COWS)评分,并进行回顾性分析。一部分患者在接受BRIDGE治疗5天后记录评分。那些返回诊所并接受第一剂维持药物治疗的患者被认为成功过渡。

结果

在这个队列(n = 73)中,65%为男性。放置BRIDGE之前的平均COWS评分为20.1(±6.1)。放置BRIDGE后20分钟,平均评分降至7.5(±5.9)(降低62.7%,p<0.001)。30分钟后评分进一步降至4.0(±4.4),60分钟后降至3.1(±3.4)(降低84.6%,p<0.001)。在此期间未使用抢救药物。第5天的平均戒断评分为0.6(降低97.1%,p<0.001)(n = 33)。总体而言,64/73例患者(88.8%)成功过渡到MAT。

结论

使用BRIDGE进行神经刺激与阿片类药物戒断评分降低有关。这种效果在诱导期持续存在,并有助于有效过渡到MAT。

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