Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.
Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, Miami, FL, USA.
Neuromodulation. 2020 Aug;23(6):871-877. doi: 10.1111/ner.13146. Epub 2020 Mar 20.
Ocular pain is a debilitating condition that is challenging to treat as therapies that target the ocular surface are often ineffective. We previously reported a short-term reduction in ocular pain after one periocular transcutaneous electrical nerve stimulation (TENS) session. The current study aims to elucidate the long-term effect of TENS on ocular pain.
Fourteen individuals with eye pain were identified as candidates for a TENS device (RS Medical, Vancouver) for home use after a successful trial in clinic between February 2018 and July 2019 at the Miami Veterans Administration Hospital or University of Miami. Ten of the 14 patients were included in this retrospective review, based on the inclusion of receiving and using the device for a minimum of three months. The median age of the ten patients was 47.5 years, range 32-73 years, and eight were male. The main outcome measures were 1) frequency of long-term integration of TENS into ocular pain management and 2) patient reported ocular pain intensity (0-10) pre- vs. post-treatment.
Patients reported an initial median use of the device 14.0 times per week and over time reducing the frequency to 3.0 times per week. All reported that the TENS unit was successfully incorporated into their ocular pain management routine for at least three months (median duration of use 6.5 months, range 3-14 months). Nine of ten patients reported subjective pain reduction with use of the TENS device at home. Overall, pain intensity decreased by approximately 27.4% (mean rank = 5.6, Z = -2.1, p = 0.02) post- vs. pre-treatment. No adverse events associated with TENS were reported in any patient.
Our preliminary data suggest that TENS can be integrated into the long-term management of ocular pain with improvements in overall pain intensity.
眼部疼痛是一种使人衰弱的疾病,治疗具有挑战性,因为针对眼表的治疗往往效果不佳。我们之前报道过一次眶周经皮神经电刺激(TENS)治疗后眼部疼痛短期减轻。本研究旨在阐明 TENS 对眼部疼痛的长期影响。
2018 年 2 月至 2019 年 7 月,在迈阿密退伍军人管理局医院或迈阿密大学,14 名眼部疼痛患者在诊所成功试用 TENS 设备(RS Medical,温哥华)后,被确定为该设备的家用候选者。根据至少使用三个月的设备纳入和使用情况,这 14 名患者中有 10 名纳入了这项回顾性研究。这 10 名患者的中位年龄为 47.5 岁,范围为 32-73 岁,其中 8 名男性。主要观察指标为:1)TENS 长期整合到眼部疼痛管理中的频率;2)治疗前后患者报告的眼部疼痛强度(0-10)。
患者报告初始每周使用设备中位数为 14.0 次,随着时间的推移,频率降至每周 3.0 次。所有患者均报告 TENS 装置成功纳入其眼部疼痛管理常规至少 3 个月(中位数使用时间为 6.5 个月,范围为 3-14 个月)。10 名患者中有 9 名报告在家中使用 TENS 装置后主观疼痛减轻。总体而言,疼痛强度降低了约 27.4%(平均秩=5.6,Z=-2.1,p=0.02)。没有患者报告与 TENS 相关的不良反应。
我们的初步数据表明,TENS 可以整合到眼部疼痛的长期管理中,整体疼痛强度得到改善。