Neuromodulation : journal of the International Neuromodulation Society
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Objective. This article presents an overview of the use of intrathecal bupivacaine (with and without opioid), focusing on laboratory data and clinical use for chronic pain. Some background on epidural use is included to support the intrathecal literature. ⋯ In addition, outcome studies are needed specifically to differentiate use of intrathecal bupivacaine based on the source and mechanism of pain. Conclusions. While there are few long-term randomized prospective studies at this point, we conclude that intrathecal bupivacaine appears to be a safe and efficacious treatment in both cancer and noncancer pain.
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Objective. This experiment was performed to test the hypothesis that intrathecally pumped saline, but not artificial cerebrospinal fluid (CSF), would be analgesic in a rat model of neuropathic pain. Materials and Methods. ⋯ No analgesia was observed on tests of spontaneous pain or pressure hyperalgesia (p > 0.1). Conclusions. Intrathecally pumped saline and artificial CSF have analgesic effects on some neuropathic and normal, nociceptive pain signs in CCI rats.
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Objectives. Our objective was to describe and analyze through a third party disinterested observer the results obtained by using motor cortex stimulation (MCS) for the treatment of central dysesthetic diffuse-distal type of paraplegic pain and intentional tremor secondary to the total removal of a cervical ependymoma. Design. ⋯ In this single case report MCS was extremely useful in eliminating almost all of the patient's pain-evoked phenomena. Both steady burning pain and tremor were also improved. This is only one case report and MCS warrants further investigation as to its utility in controlling central dysesthetic pain in paraplegia and postchordotomy dysesthesias.
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Objectives. The goal of this work is to study and develop an electrical integrated system that allows the control of the basic functions (such as micturition, defecation, and erection) by sacral root stimulation in paraplegic patients. Materials and Methods. ⋯ The architecture of the new stimulator, applied over the sacral roots, can be used to control the voiding of the bladder. The system allows an independent distance programmable stimulation. The impedance measurement circuit implemented allows an easy and systematic performance test.
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The objective of this study was to examine the programming strategies used in patients with intractable low-back pain treated with epidural spinal cord stimulation (SCS) utilizing paddle electrodes and a radio frequency (RF) stimulator. Programming strategies were examined in a group of patients implanted with a 16-contact paddle electrode and a dual channel RF receiver to treat chronic low-back pain. Baseline data included previous surgical history information, leg and low back pain severity and characteristics, and routine demographic information. ⋯ The system must provide the capability to redirect the current electronically over at least two segments of the spinal canal, to electronically steer the current in a medio-lateral direction, and to activate multiple electrical contacts simultaneously. The willingness and ability to provide extensive reprogramming in the long term follow-up is also of the utmost importance. Pain and its treatment with SCS is a dynamic process.