Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Pain Med. 2021 Nov 26;22(11):2763-2767. doi: 10.1093/pm/pnab105.
Spinal cord stimulation (SCS) is used to treat a variety of chronic pain conditions refractory to more conservative management including refractory angina pectoris. We identified 31 patients who underwent SCS implantation for the indication of refractory angina at a single institution from 2003 through 2018. Sixteen patients were male, and 15 were female. Average age was 53.9 years. Prior to SCS implantation, all patients had at least one coronary angiogram. Ten (32.3%) patients had undergone percutaneous coronary intervention, and four (12.9%) had undergone coronary artery bypass grafting. Thirty patients (96.7%) were currently using anti-angina medications. Twenty-six patients (83.9%) were on antiplatelet or anticoagulant agents at the time of SCS evaluation. Spinal cord stimulation implanters must perform a comprehensive evaluation incorporating appropriate multidisciplinary care particularly in patients with refractory angina given their cardiovascular comorbidities. It is important to have baseline data (e.g., pain scores, nitroglycerin consumption, frequency of angina episodes, and a questionnaire, such as the Seattle Angina Questionnaire) to compare with follow-up data to help define treatment success. We report a single institution's pre-operative experience for patients undergoing SCS for refractory angina to illustrate unique pre-operative SCS considerations in this chronic pain population.
脊髓刺激 (SCS) 用于治疗多种慢性疼痛病症，这些病症对更保守的治疗方法（包括难治性心绞痛）无效。我们在一家机构中确定了 31 名因难治性心绞痛而接受 SCS 植入的患者，这些患者的病例发生在 2003 年至 2018 年期间。16 名患者为男性，15 名患者为女性。平均年龄为 53.9 岁。在进行 SCS 植入之前，所有患者都至少进行过一次冠状动脉造影。10 名（32.3%）患者接受了经皮冠状动脉介入治疗，4 名（12.9%）患者接受了冠状动脉旁路移植术。30 名患者（96.7%）正在使用抗心绞痛药物。在 SCS 评估时，26 名患者（83.9%）正在使用抗血小板或抗凝药物。脊髓刺激植入器必须进行全面评估，包括适当的多学科护理，特别是对于患有难治性心绞痛的患者，因为他们有心血管合并症。重要的是要有基线数据（例如，疼痛评分、硝化甘油消耗、心绞痛发作频率和西雅图心绞痛问卷等问卷）与随访数据进行比较，以帮助确定治疗成功。我们报告了一家机构中接受 SCS 治疗难治性心绞痛的患者的术前经验，以说明在这种慢性疼痛人群中，SCS 术前有独特的考虑因素。
