Neuromodulation : journal of the International Neuromodulation Society
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Review Meta Analysis
Transcutaneous Electrical Nerve Stimulation As A Pain-Relieving Approach in Labor Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Transcutaneous electrical nerve stimulation (TENS) is a non-invasive electrophysical pain-relieving modality that also can be used in labor pain. Compared to other methods, TENS is not commonly practiced in intrapartum care due to a lack of knowledge about its clinical efficacy. Hence, a comprehensive overview of all types of randomized controlled trials (RCTs) on TENS can provide a better insight into this method and its efficacy in labor pain. ⋯ The forest plot showed a small, but statistically significant efficacy of TENS on the reduction of pain intensity. However, it is not clear if the results were affected by the poor quality of the studies. This systematic review is the first that shows the application of TENS has significant efficacy in lowering labor pain. Findings from this review encourage the application of qualified methods for future and prospective studies with TENS applied in labor pain.
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Review Meta Analysis
Cervical Noninvasive Vagus Nerve Stimulation for Migraine and Cluster Headache: A Systematic Review and Meta-Analysis.
Noninvasive vagus nerve stimulation (nVNS) has been proposed as a new neuromodulation therapy to treat primary headache disorders. The purpose of this study was to analyze the effectiveness and safety of peripheral nerve stimulation of the cervical branch of the vagal nerve for primary headache disorders. ⋯ PROSPERO registration number CRD42019126009.
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Review Case Reports
Use of non-invasive vagus nerve stimulation to treat respiratory symptoms associated with COVID-19: A theoretical hypothesis and early clinical experience.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a pandemic with no specific therapeutic agents and substantial mortality, and finding new treatments is critical. Most cases are mild, but a significant minority of patients develop moderate to severe respiratory symptoms, with the most severe cases requiring intensive care and/or ventilator support. This respiratory compromise appears to be due to a hyperimmune reaction, often called a cytokine storm. Vagus nerve stimulation has been demonstrated to block production of cytokines in sepsis and other medical conditions. We hypothesize that non-invasive vagus nerve stimulation (nVNS) might provide clinical benefits in patients with respiratory symptoms similar to those associated with COVID-19. ⋯ Preliminary observations and a strong scientific foundation suggest that nVNS might provide clinical benefits in patients with COVID-19 via multiple mechanisms.
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Randomized Controlled Trial
Effects and Mechanisms of Transcutaneous Electrical Acustimulation on Postoperative Recovery After Elective Cesarean Section.
To explore the effects and mechanisms of transcutaneous electrical acustimulation (TEA) on postoperative recovery after cesarean section (CS). ⋯ Needleless non-invasive TEA at ST36 is effective in promoting both lower and upper GI symptoms after CS by enhancing vagal and suppressing sympathetic activities [Correction added on 23 June 2020, after first online publication: The first word of the preceded sentence has been corrected.].
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Neuromodulation for trigeminal pain syndromes such as trigeminal neuropathic pain (TNP) necessitates accurate localization of foramen ovale (FO). The Härtel-type approach is very well-established and safe, ideal for temporary cannulation of the FO for ablative procedures such as balloon microcompression. A key shortcoming of the Hartel approach for placement of neuromodulation leads is the limited opportunity for secure anchoring. The aim of this study is to introduce a novel surgical approach for the treatment of TNP by investigating key osseous landmarks and their spatial relationships to the FO. ⋯ This study provides a novel means of approaching the FO via transoral gingival buccal access.