Abd-Elsayed Alaa, Keith Mitchell K, Cao Nancy N, Fiala Kenneth J, Martens Joshua M
Department of Anesthesiology, Division of Chronic Pain Medicine, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, B6/319 CSC, Madison, WI, 53792-3272, USA.
Pain Ther. 2023 Dec;12(6):1415-1426. doi: 10.1007/s40122-023-00557-3. Epub 2023 Sep 22.
Chronic pain is a growing problem across the world, and in the midst of an opioid epidemic, it is imperative that alternative treatment measures are identified to help alleviate the pain experienced by these patients. Chronic pain greatly affects ones quality of life and many patients do not experience adequate relief with conventional treatment measures. The purpose of this retrospective analysis is to assess the efficacy of peripheral nerve stimulation (PNS) therapy in adult patients suffering from chronic pain refractory to conventional treatment measures who underwent therapy on various anatomical locations.
This retrospective analysis consisted of data collected from electronic health records for n = 89 patients who underwent PNS therapy. Data collected relates to patient age, sex, weight, height, body mass index (BMI), diagnosis, targeted nerves, follow-up encounters, pain scores from before and after PNS therapy, and duration of improvement. Statistical analysis used SPSS software, version 26 (IBM), using a paired t test to assess significance between pre and post PNS therapy pain scores. P values were significant if found to be ≤ 0.05. Further analysis assessed the correlation between age and BMI with visual analog scale (VAS) pain improvement and subjective percentage pain relief.
The mean pre-operative (pre-op) pain score before PNS therapy was 6.36 (standard deviation (SD) = 2.18, SEM = 0.23) and the mean post-operative (post-op) pain score after PNS therapy was 4.19 (SD = 2.70, SEM = 0.29). The mean patient-reported percent improvement in pain following PNS therapy was 49.04% (SD = 34.79). The improvement in pain scores between pre-op and post-op was statistically significant (M = 2.17, SD = 2.82, SEM = 0.30, t(88) = 7.26, p < .001), 95% confidence interval (CI) [1.57, 2.76]. The mean duration of improvement for patients was 123 days after therapy initiation (min = 6, max = 683, SD = 126).
This study demonstrated the potential role for PNS therapy in improving patient-reported pain levels for various neuropathies, targeting various nerves. With PNS therapy's use as a chronic pain treatment and available research being limited, further study needs to be done on the efficacy of PNS therapy for pain management and complications associated with PNS device placements at various locations.
慢性疼痛在全球范围内日益严重，在阿片类药物泛滥的情况下，必须确定替代治疗措施，以帮助缓解这些患者的疼痛。慢性疼痛极大地影响患者的生活质量，许多患者采用传统治疗措施后疼痛并未得到充分缓解。本回顾性分析的目的是评估外周神经刺激（PNS）疗法对成年慢性疼痛患者的疗效，这些患者对传统治疗措施无效且接受了不同解剖部位的治疗。
本回顾性分析的数据来自89例接受PNS治疗患者的电子健康记录。收集的数据包括患者年龄、性别、体重、身高、体重指数（BMI）、诊断、靶向神经、随访情况、PNS治疗前后的疼痛评分以及改善持续时间。使用SPSS 26版软件（IBM公司）进行统计分析，采用配对t检验评估PNS治疗前后疼痛评分的差异。P值≤0.05具有统计学意义。进一步分析评估年龄和BMI与视觉模拟量表（VAS）疼痛改善及主观疼痛缓解百分比之间的相关性。
PNS治疗前的平均术前疼痛评分为6.36（标准差（SD）=2.18，标准误（SEM）=0.23），治疗后的平均术后疼痛评分为4.19（SD=2.70，SEM=0.29）。患者报告的PNS治疗后疼痛平均改善百分比为49.04%（SD=34.79）。术前和术后疼痛评分的改善具有统计学意义（M=2.17，SD=2.82，SEM=0.30，t(88)=7.26，p<.001），95%置信区间（CI）[1.57, 2.76]。患者改善的平均持续时间为治疗开始后123天（最小值=6，最大值=683，SD=126）。
本研究证明了PNS疗法在改善患者报告的各种神经病变、靶向不同神经的疼痛水平方面的潜在作用。鉴于PNS疗法作为慢性疼痛治疗方法的应用且现有研究有限，需要进一步研究PNS疗法在疼痛管理中的疗效以及与不同部位PNS装置植入相关的并发症。
