Char Steven, Jin Max Y, Francio Vinicius Tieppo, Hussain Nasir, Wang Eric J, Morsi Mahmoud, Orhurhu Vwaire, Prokop Larry J, Fink Adam, D'Souza Ryan S
Department of Anesthesiology & Perioperative Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
Department of Anesthesiology, University of Wisconsin-Madison, Madison, WI 53706, USA.
Biomedicines. 2022 Oct 17;10(10):2606. doi: 10.3390/biomedicines10102606.
Peripheral nerve stimulation (PNS) has been utilized for over 50 years with accumulating evidence of efficacy in a variety of chronic pain conditions. The level and strength of evidence supporting the use of PNS for peripheral neuropathic pain remains unclear. The purpose of this review is to synthesize data from prospective studies on the efficacy of PNS for neuropathic pain as it pertains to pain intensity, neurological deficits/neuropathy (e.g., weakness, sensory deficits, gait/balance), and other secondary outcomes (quality of life, satisfaction, emotional functioning, and adverse events). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, this review identified articles from MEDLINE(R), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus. Overall, per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, pooled results demonstrate very low quality or low quality of evidence supporting modest to substantial improvement in pain and neurological function after PNS implantation for treatment of peripheral neuropathic pain. PNS for phantom limb pain was the only indication that had moderate level evidence. Future prospective and well-powered studies are warranted to assess the efficacy of PNS for peripheral neuropathic pain.
外周神经刺激（PNS）已被应用50多年，越来越多的证据表明其在多种慢性疼痛病症中具有疗效。支持将PNS用于治疗外周神经性疼痛的证据水平和强度仍不明确。本综述的目的是综合前瞻性研究的数据，这些研究涉及PNS治疗神经性疼痛的疗效，包括疼痛强度、神经功能缺损/神经病变（如无力、感觉缺损、步态/平衡）以及其他次要结局（生活质量、满意度、情绪功能和不良事件）。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，本综述从医学文献数据库（MEDLINE®）、EMBASE、Cochrane对照试验中心注册库、Cochrane系统评价数据库和Scopus中检索文章。总体而言，根据推荐分级评估、制定与评价（GRADE）标准，汇总结果显示，支持PNS植入治疗外周神经性疼痛后疼痛和神经功能有中度至显著改善的证据质量非常低或质量低。PNS用于治疗幻肢痛是唯一有中等证据水平的适应症。未来有必要开展前瞻性且样本量充足的研究，以评估PNS治疗外周神经性疼痛的疗效。
