Strege D W, Cooney W P, Wood M B, Johnson S J, Metcalf B J
Division of Hand Surgery, Mayo Clinic, Rochester, MN 55905.
J Hand Surg Am. 1994 Nov;19(6):931-9. doi: 10.1016/0363-5023(94)90092-2.
Chronic somatic peripheral nerve pain was treated prospectively in 24 nonrandomized patients by a program of direct electrical nerve stimulation. Patients qualified for the program if anesthetic (lidocaine) nerve block of the involved cutaneous zone of the peripheral nerve relieved symptoms and transcutaneous electrical nerve stimulation transiently improved and did not exacerbate somatic pain. Results were judged according to a pain score. Patients noted improved sleep and complete absence of the need for narcotic pain medication. On the basis of subjective and objective criteria, 18 patients had good or excellent results and 6 had implant failures. Of the six patients with failures, three failed the trial period and did not have implantation, and three had no significant pain relief and were judged as treatment failures. Three patients had late equipment failure after initial good results. Most patients had some relief of pain, which increased their quality of life and eliminated the need for narcotic analgesia. Direct electrical nerve stimulation should be considered for somatic peripheral nerve pain that has not been ameliorated with other methods. It will reduce, although not necessarily eliminate, pain and pain behavior in most patients.
采用直接电神经刺激方案对24例非随机选择的患者进行了慢性躯体性周围神经痛的前瞻性治疗。如果外周神经受累皮肤区域的麻醉（利多卡因）神经阻滞能缓解症状，且经皮电神经刺激能暂时改善且不加重躯体疼痛，则患者符合该方案标准。根据疼痛评分判断结果。患者表示睡眠改善，完全无需使用麻醉性止痛药物。根据主观和客观标准，18例患者效果良好或极佳，6例植入失败。在6例失败患者中，3例在试验期失败未进行植入，3例疼痛未得到明显缓解，被判定为治疗失败。3例患者在初期效果良好后出现晚期设备故障。大多数患者的疼痛得到了一定程度的缓解，这提高了他们的生活质量，不再需要麻醉性镇痛。对于其他方法无法改善的躯体性周围神经痛，应考虑直接电神经刺激。它将减轻大多数患者的疼痛和疼痛行为，尽管不一定能消除。
