Neuromodulation : journal of the International Neuromodulation Society
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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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Objective. Intrathecal opioid/local anesthetic mixtures are a popular alternative in contemporary treatment of chronic nonmalignant pain. Unfortunately, its use is based solely on retrospective studies or anecdotal reports. ⋯ Addition of bupivacaine to the intrathecal opioid failed to produce significant improvement in pain control. Conclusion. At currently used doses, intrathecal opioid bupivacaine mixtures are not more efficacious in the treatment of chronic nonmalignant pain than opioid alone.
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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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We modified a commercial indoor rowing machine (Concept 2 Inc., Morrisville, NJ, USA) for a functional electrical stimulation (FES) assisted indoor rowing exercise in which the rowers must repeatedly press the two switches on the handle that stimulate their paralyzed leg muscles. The objective of this study was to automate the delivery of electrical stimulation to prevent potential repetitive strain injuries and to expand the user base to clients with impaired hand function. The modifications for development of the FES rowing machine and clinical trials were all performed in the University of Alberta. ⋯ Two paraplegic users of the older manual control system tested the new automatic controller. The automatic FES controller spent more electrical stimulation per rowing cycle but it did not require repetitive thumb presses, required less concentration, and was preferred by the clients. We conclude FES rowing with the new automatic controller was easier and safer and expanded the user base of the FES rowing exercise to those with affected hand.