Dorsal Root Ganglion Stimulation for Chronic Postoperative Pain Following Thoracic Surgery: A Pilot Study.


Journal

Neuromodulation : journal of the International Neuromodulation Society
ISSN: 1525-1403
Titre abrégé: Neuromodulation
Pays: United States
ID NLM: 9804159

Informations de publication

Date de publication:
Jun 2021
Historique:
revised: 13 07 2020
received: 27 05 2020
accepted: 05 08 2020
pubmed: 11 9 2020
medline: 19 8 2021
entrez: 10 9 2020
Statut: ppublish

Résumé

Post-thoracotomy pain syndrome (PTPS) is defined as persistent pain following a thoracotomy and has an incidence of 21-61%. Dorsal root ganglion stimulation (DRG-S) is a form of neuromodulation that modulates pain signal transmission to the spinal cord. The aims of this study were to investigate the efficacy of DRG-S for the management of PTPS and to assess the role of thoracic paravertebral blocks (t-PVB) as a tool for prediction of success of DRG-S. In this prospective study, we included all patients undergoing thoracic surgery, with PTPS not responding to pharmacotherapy and treated with DRG-S from September 2018 to February 2019. t-PVB followed by a percutaneous DRG-S trial was performed on all patients. Pain intensity was assessed through a numeric rating scale (NRS) and Douleur Neuropathique en 4 Questions (DN4) at baseline, post-trial, at 14 days, 90 days, and at one year after DRG-S implantation. Data summarized as continuous variables were expressed as means and standard deviations (SDs), and categorical variables were expressed as raw numbers and percentages. Four patients out of 51 who underwent thoracic surgery at our institution surveyed were included (mean age ± SD, 56 ± 16 years old). Mean NRS and DN4 were, respectively, 7.2 ± 0.96 SD and 8.2 ± 0.5 SD at baseline, 2.5 ± 0.6 SD and 3.2 ± 0.5 SD after t-PVB, 2.2 ± 0.5 SD and 2.2 ± 0.5 SD at 14 days, 90 days, and at one year after DRG-S implantation. No complications or side effects were reported. Our preliminary results show that DRG-S is an effective therapy for PTPS after thoracic surgery. In addition, thoracic paravertebral blocks performed prior to DRG-S correlated with a positive outcome with treatment.

Identifiants

pubmed: 32909359
doi: 10.1111/ner.13265
pii: S1094-7159(21)00015-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

774-778

Informations de copyright

© 2020 International Neuromodulation Society.

Références

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Auteurs

Giuliano Lo Bianco (G)

Pain Department, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.
Università di Catania, Dipartimento di Scienze Biomediche e Biotecnologiche (BIOMETEC), Catania, Italy.
Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy.
Pain Management and Neuromodulation, Basildon and Thurrock University Hospitals NHSFT, Orsett Hospital, London, UK.

Alfonso Papa (A)

Pain Department, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.

Giuseppe Gazzerro (G)

Pain Department, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.

Marco Rispoli (M)

Anesthesiology Department, Thoracic Surgery, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.

Dario Tammaro (D)

Pain Department, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.
Anesthesiology Department, Thoracic Surgery, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.

Maria Teresa Di Dato (MT)

Pain Department, A.O. Dei Colli - V. Monaldi Hospital, Napoli, Italy.

Federica Vernuccio (F)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.

Michael Schatman (M)

Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA.
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.

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