Mücke M, Schulze H, Radbruch L, Marinova M, Cuhls H, Kravchenko D, Conrad R, Rolke R
Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland.
Institut für Hausarztmedizin, Universitätsklinikum Bonn, Bonn, Deutschland.
Schmerz. 2017 Dec;31(6):594-600. doi: 10.1007/s00482-017-0233-y.
There is currently a lack of studies that evaluate the effects of matrix electrode neuromodulation on acute pain. In this prospective and randomized cross-over study, we investigated the efficacy of 4 Hz-matrix stimulation on venipuncture-induced pain in 30 healthy subjects.
We compared two conditions of neurostimulation: in EC1 (experimental condition 1), we performed venipuncture during stimulation, with 2.5 min of prestimulation with 600 stimuli; in EC2 (experimental condition 2), the length of stimulation was 5 min, at 1200 stimuli, with subsequent venipuncture. A group with no stimulation was used as control condition.
The EC2 group did not only show a 77% reduction in puncture pain when compared to the control group (p < 0.001; effect size [ES] d = 1.45), but also had a significant effect compared with EC1 (p < 0.001; ES d = 1.33). EC1, on the other hand, did not demonstrate a significant difference to the control group. The status of the veins was evaluated based on visibility and did not differ significantly between the conditions.
The results of this study showed for the first time that pre-emptive matrix stimulation could be an effective way to reduce acute pain. The duration of stimulation seems to play a key role in the effectiveness of the neurophysiological mechanism of action. Matrix stimulation is a therapeutic intervention with very few side effects, which could, in the future, expand our pain-management options for the treatment of acute pain.
目前缺乏评估矩阵电极神经调节对急性疼痛影响的研究。在这项前瞻性随机交叉研究中,我们调查了4赫兹矩阵刺激对30名健康受试者静脉穿刺所致疼痛的疗效。
我们比较了两种神经刺激条件:在EC1(实验条件1)中,我们在刺激期间进行静脉穿刺,先进行600次刺激、持续2.5分钟的预刺激;在EC2(实验条件2)中,刺激时长为5分钟,共1200次刺激,随后进行静脉穿刺。将无刺激组作为对照条件。
与对照组相比,EC2组不仅穿刺疼痛减轻了77%(p < 0.001;效应量[ES] d = 1.45),而且与EC1组相比也有显著效果(p < 0.001;ES d = 1.33)。另一方面,EC1组与对照组相比未显示出显著差异。根据可见度评估静脉状态,各条件之间无显著差异。
本研究结果首次表明,预先进行矩阵刺激可能是减轻急性疼痛的有效方法。刺激时长似乎在神经生理作用机制的有效性中起关键作用。矩阵刺激是一种副作用极少的治疗干预措施,未来可能会扩展我们治疗急性疼痛的疼痛管理选择。