Neuromodulation : journal of the International Neuromodulation Society
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Comparative Study
Sufentanil versus fentanyl: efficacy and patient satisfaction with intrathecal pain management.
This study compared fentanyl vs. sufentanil in intrathecal pain pumps. H1: both reduce patient subjective pain ratings. H2: sufentanil is more effective than fentanyl. H3: overall satisfaction with pain control is greater with sufentanil. ⋯ Sufentanil was found to be marginally more effective, but both medications controlled a significant degree of variance in pain reduction over time. A significantly greater number of patients maintained on sufentanil were satisfied with care than patients on fentanyl.
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Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal-peripheral neurostimulation (SPN) was used via a caudal approach. ⋯ SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement.
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With the advent of rechargeable internal neural stimulators (rINS) for deep brain stimulation, our aim was to survey patient satisfaction and clinical efficacy in an early cohort of patients receiving this new technology. ⋯ Most patients were happy with their rechargeable internal neural stimulator. A reduction in efficacy was noticed in 22% of patients, which is similar to the proportion of patients noticing a reduction in efficacy when replacing with a non-rechargeable system. Thus, all patients require close monitoring post-replacement of rINS, in case possible adjustment of parameters is required.
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We report a retrospective case study of combined treatment of cancer-related pain and chronic low back and lower extremity pain related to postlaminectomy syndrome (PLS) with one spinal cord stimulation (SCS) system. ⋯ SCS provides an effective, alternative treatment for select patients with cancer-related chest wall pain and pain related to PLS who have failed conservative treatment.