Harsh Viraat, Mishra Parijat, Gond Preeti K, Kumar Anil
a Department of Neurosurgery , Rajendra Institute of Medical Sciences , Ranchi , India.
Br J Neurosurg. 2019 Jun;33(3):332-336. doi: 10.1080/02688697.2018.1538479. Epub 2019 Apr 7.
Unbearable chronic neuropathic pain, which can often not be resolved by conservative pain management techniques, calls for peripheral nerve stimulation. The technique, based on the Gate control hypothesis, uses low intensity current to block depolarization and conduction of neuronal membrane. Conditions such as intractable migraine, occipital and trigeminal neuralgia, burn injury pain, transformed migraine, among others, which cause intense pain can be treated by PNS, especially when the pain is localised and can be traced back to a specific nerve. Complication rates in PNS vary from 5% in some cases to 43% in others. Common complications include lead breakage, electrode migration, etc., meanwhile complications associated with every surgery like risks of anaesthesia, bleeding etc., are also present. PNS shows great potential in the treatment of intractable pain, and with its less invasiveness, high success rate, and development of advanced technologies like BION and SAINT, it is bound to become a standard procedure in the future for neuropathic pain management.
难以忍受的慢性神经性疼痛通常无法通过保守的疼痛管理技术得到缓解，因此需要进行外周神经刺激。该技术基于闸门控制假说，利用低强度电流来阻断神经元膜的去极化和传导。诸如顽固性偏头痛、枕神经和三叉神经痛、烧伤疼痛、转化型偏头痛等引起剧痛的病症都可以通过外周神经刺激进行治疗，尤其是当疼痛局限且可追溯到特定神经时。外周神经刺激的并发症发生率在某些情况下为5%，在其他情况下为43%。常见并发症包括导线断裂、电极移位等，同时还存在与所有手术相关的并发症，如麻醉风险、出血等。外周神经刺激在治疗顽固性疼痛方面显示出巨大潜力，并且由于其侵入性较小、成功率高以及诸如BION和SAINT等先进技术的发展，它必将在未来成为神经性疼痛管理的标准程序。
