2024-03-29T15:42:49Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00021060
2022-12-15T03:51:39Z
453:456
471:537:538:1175
Subjective and Objective Evaluation of Pain Relief by Epidural Spinal Cord Stimulation
硬膜外脊髄通電法の自覚的及び他覚的除痛効果について
硬膜外脊髄通電法の自覚的及び他覚的除痛効果について
穂苅, 環
129198
epidural spinal cord stimulation
skin temperature
R3 response
transcutaneous electrical nerve stimulation
硬膜外脊髄通電
皮膚温
R3反応
経皮的末梢神経刺激
More than 200 patients with chronic pain were treated by epidural spinal cord stimulation (ESCS). The effects of ESCS on subjective pain relief were evaluated in relation to the type of diseases. ESCS was significantly (p<0.005) more effective in cancer pain, traumatic cervical syndrome and tabes dorsalis with comparison to other diseases. On the other hand, ESCS was significantly (p<0.005) less effective in thromboarteritis obliterans and arteriosclerosis obliterans. Significant (p<0.005) decrease in amount of anodynes and minor tranquilizers were noted following pain relief with ESCS. Other treatments such as oral administration of analgesics and nerve blocks (including sympathetic block) were not effective in these patients subjected to ESCS. Thus the score of our ESCS that 54.6% of the patients achieved more than 50% subjective pain relief seemed to be high with comparison to that reported by other investigators on ESCS. Subjective pain relief by ESCS was significantly correlated to the rise of skin temperature (p<0.01) and the depression of the withdrawal reflex (p<0.05) measured by electromyogram (R3 response). Subjective pain relief by transcutaneous electrical nerve stimulation (TENS) was also significantly (p<0.01) correlated to pain relief by ESCS. Therefore measurements of skin temperature and R3 response during ESCS is useful for evaluation of objective pain relief. TENS should also be tried for prediction of the effect of ESCS, since the method is very simple. Thus, objective evaluations of pain relief such as measurements of skin temperature and R3 responses might be valuable for prediction of effectiveness of ESCS on the patients with chronic pain. A simple subjective estimation of pain relief with TENS might also be beneficial for prediction of the pain relieving effects of ESCS.
departmental bulletin paper
新潟医学会
1992-04
application/pdf
新潟医学会雑誌
4
106
333
340
新潟医学会雑誌
AN00182415
00290440
https://niigata-u.repo.nii.ac.jp/record/21060/files/106(04)_333-340.pdf
jpn