• Teodor Goroszeniuk, Sandesha Kothari, and Wolfgang Hamann.
• Pain Management Center, St. Thomas' and Guys Hospital, London SE1 7EH, United Kingdom.
• Reg Anesth Pain Med. 2006 Mar 1;31(2):168-71.

IntroductionPrimary afferent stimulation for the control of chronic pain frequently offers the optimal compromise for the control of intractable pain. We describe a new access route directly to the site of pain (target) in the form of subcutaneous targeted neurostimulation (STN) via a percutaneous permanent neurostimulating implant.Case ReportWe present 3 cases with chronic intractable pain where STN via a permanent neurostimulating implant was introduced successfully. STN for 1-2 hours daily produced pain relief lasting between 12 to 24 hours, which argues that subcutaneous neurostimulation instead of stimulation of peripheral nerves is sufficient in selected cases. The effects of subcutaneous stimulation do not correlate with transcutaneous electrical nerve stimulation applied externally over the same area.ConclusionThe introduction of an STN directly to painful areas, therefore bypassing the spinal cord and peripheral nerves, is a novel and simple procedure that is effective, in this small series, for control of intractable pain consistent with neuropathic pain.

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