Fares Khaled M, Mohamed Sahar A B, Hetta Diab F, Tohamy Moaaz Mohamed, Elgalaly Nourhan A, Elhusseini Nayira M, El Sherif Fatma Adel
Department of Anesthesia, ICU, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Saudi J Anaesth. 2024 Oct-Dec;18(4):534-539. doi: 10.4103/sja.sja_307_24. Epub 2024 Oct 2.
Neuromodulation has provided promising results in chronic pain management. Sacral neurostimulation (SNS) is a neuromodulatory technique, where the sacral nerve roots are electrically stimulated.
Evaluate the efficacy of the trial phase to control severe cancer pain in pelvic organs.
Pilot study.
Chronic pelvic cancer pain patients were managed with morphine ≥ 60 mg daily, duloxetine 30 mg, and celecoxib 200 mg twice daily. Twenty-two adults were divided randomly into two equal groups: the SNS group (N = 11), received a sacral neurostimulator device and opioid analgesics, and the opioid group (N = 11), received increased opioid analgesics to control pain.
Visual analog scale scores were decreased in the SNS group at 24 h, 4 days, 1, and 2 weeks in SNS compared to the opioid group, medians (IQR) [4 (3-5) vs 6 (5-7), 3 (3-4) vs 5 (5-6), 3 (3-4) vs 5 (5-6), and 3 (3-3) vs 5 (4-6) < 0.001], daily morphine consumption was reduced in the SNS group compared to the opioid group, median (IQR) [90 (60-90) mg vs 120 (120-150) mg, < 0.001] and [30 (30-60) mg vs 150 (120-180) mg] during the first and second weeks. The SNS group had a better life quality compared to the opioid group after 2 weeks, median (IQR) was (123 (122.5-124) vs 117 (117-118.5) < 0.001), respectively.
The SNS trial device showed effectiveness in managing severe chronic pelvic cancer pain.
神经调节在慢性疼痛管理中已取得了有前景的成果。骶神经刺激（SNS）是一种神经调节技术，通过对骶神经根进行电刺激。
评估试验阶段控制盆腔器官严重癌痛的疗效。
前瞻性研究。
慢性盆腔癌痛患者每日服用吗啡≥60mg、度洛西汀30mg以及塞来昔布200mg，每日两次。22名成年人被随机分为两组，每组11人：SNS组接受骶神经刺激器装置和阿片类镇痛药，阿片类药物组则增加阿片类镇痛药剂量以控制疼痛。
与阿片类药物组相比，SNS组在24小时、4天、1周和2周时视觉模拟量表评分降低，中位数（四分位间距）分别为[4（3 - 5）对6（5 - 7），3（3 - 4）对5（5 - 6），3（3 - 4）对5（5 - 6），以及3（3 - 3）对5（4 - 6）]<0.001；与阿片类药物组相比，SNS组在第一周和第二周的每日吗啡消耗量降低，中位数（四分位间距）分别为[90（60 - 90）mg对120（120 - 150）mg，<0.00１]和[30（30 - 60）mg对150（120 - 180）mg]。2周后，SNS组的生活质量优于阿片类药物组，中位数（四分位间距）分别为（123（122.5 - 124）对117（117 - 118.5）<0.001）。
SNS试验装置在管理严重慢性盆腔癌痛方面显示出有效性。
