临时和永久性周围神经刺激后的疼痛强度与阿片类药物消耗：一项为期两年的多中心分析。

Pain intensity and opioid consumption after temporary and permanent peripheral nerve stimulation: a 2-year multicenter analysis.

作者信息

West Tyler, Hussain Nasir, Bhatia Anuj, ElSaban Mariam, Kilgore Anthony E, Palettas Marilly, Abdel-Rasoul Mahmoud, Javed Saba, D'Souza Ryan S

机构信息

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

出版信息

Reg Anesth Pain Med. 2024 Jul 26. doi: 10.1136/rapm-2024-105704.

DOI:10.1136/rapm-2024-105704

PMID:39060006

Abstract

OBJECTIVE

Peripheral nerve stimulation (PNS) is an emerging neuromodulation modality, yet there remains limited data highlighting its long-term effectiveness. The objective of this study was to report real-world data on pain intensity and opioid consumption after temporary and permanent PNS for chronic pain up to 24 months postimplantation.

METHODS

A retrospective study was conducted on all patients who received PNS implants at a multi-centered enterprise between January 1, 2014 and February 24, 2022. The two co-primary outcomes were: (1) change in pain intensity (11-point Numerical Rating Scale) from baseline to 12 months postimplant; and (2) comparison of the change in pain intensity between temporary and permanent PNS cohorts 12 months postimplant.

RESULTS

126 patients were included in this analysis. Pain intensity significantly decreased 12 months postimplant in the overall cohort (mean difference (MD) -3.0 (95% CI -3.5 to -2.4), p<0.0001). No significant difference in this reduction was identified between temporary and permanent PNS cohorts (MD 0.0 (95% CI -1.1 to 1.0), p=1.00) 12 months postimplantation. Pain intensity significantly decreased in the overall, temporary, and permanent cohorts at all secondary time points (3, 6, and 24 months). No change in daily opioid consumption was observed at 6 and 12 months postimplant in the overall cohort.

CONCLUSION

This study found that both temporary and permanent PNS may be effective for reducing pain intensity in patients with chronic pain up to 24 months postimplantation, although no changes in opioid consumption were observed. The decrease in pain intensity was comparable between patients receiving temporary versus permanent implants, highlighting that temporary PNS may achieve long-lasting clinical benefits. However, given the substantial loss to follow-up, further large-scale studies are needed to solidify conclusions about the efficacy of PNS.

摘要

目的

外周神经刺激（PNS）是一种新兴的神经调节方式，但突出其长期有效性的数据仍然有限。本研究的目的是报告慢性疼痛患者在植入临时和永久性PNS后长达24个月的疼痛强度和阿片类药物消耗的真实世界数据。

方法

对2014年1月1日至2022年2月24日期间在一家多中心企业接受PNS植入的所有患者进行了一项回顾性研究。两个共同主要结局是：（1）从基线到植入后12个月疼痛强度的变化（11点数字评分量表）；（2）植入后12个月临时和永久性PNS队列之间疼痛强度变化的比较。

结果

本分析纳入了126例患者。在整个队列中，植入后12个月疼痛强度显著降低（平均差值（MD）-3.0（95%CI -3.5至-2.4），p<0.0001）。植入后12个月，临时和永久性PNS队列之间在这种降低方面未发现显著差异（MD 0.0（95%CI -1.1至1.0），p=1.00）。在所有次要时间点（3、6和24个月），整个队列、临时队列和永久性队列的疼痛强度均显著降低。在整个队列中，植入后6个月和12个月未观察到每日阿片类药物消耗量的变化。