Neuromodulation : journal of the International Neuromodulation Society
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The objectives of this study were to examine the effects of ipsilateral vs. contralateral as well as simultaneous placement of transcutaneous electrical nerve stimulation (TENS) electrodes in somatic receptive fields on spontaneous and noxiously evoked dorsal horn cell activity in anesthetized cats. Recordings were made from cells in the left gray matter of lumbosacral segments. In this study ipsilateral means left and contralateral means right. ⋯ When comparing contralateral vs. ipsilateral effects, the most significant reduction (p < 0.004) in mean cell activity occurred with ipsilateral (left) placement of the electrodes. For bilateral application (simultaneous ipsilateral and contralateral) of TENS electrodes, 66% of the cells demonstrated a significant additive effect in reducing spontaneous and noxiously evoked cell activity. Clinically, the results might suggest that analgesia can result from bilateral placement of electrodes or by placement of electrodes in the contralateral dermatome (somatic field) when certain clinical conditions may prevent the placement of electrodes on the same side (ipsilateral) as the perceived pain.
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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 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.