Neuromodulation : journal of the International Neuromodulation Society
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Introduction. Intrathecal octreotide has been considered an alternative to opioids in chronic infusion for pain. Octreotide is an analog of the growth hormone sandostatin. Previous work has shown the drug to be efficacious in cancer patients who had failed intrathecal opioids. ⋯ The Saint Francis Hospital IRB and FDA approved the ongoing use of intrathecal octreotide for research. Conclusions. Intrathecal octreotide, at doses as high as 20 µg/hr, appeared to be as safe as saline when given as a continuous intrathecal infusion. Further work is needed on dose-range analysis and efficacy.
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Diaphragm pacing stimulation (DPS) for ventilator-dependent patients provides several advantages over conventional techniques such as phrenic nerve pacing or mechanical ventilator support. To date, the only existing system for DPS uses lead electrodes, percutaneously attached to an external pulse generator (PG). However, for a widespread use of this technique it would be more appropriate to eliminate the need for percutaneous wire and use a totally implantable system. ⋯ We found that TV increased with increases in charge and frequency as expected when stimulating the patient's electrodes individually and in combination with each PG system. These results are a significant step toward developing a totally implantable DPS system for the ventilator-dependant patients. Further clinical tests to demonstrate the safety and efficacy of a fully implanted DPS system are warranted.