The Pain Management and Neuromodulation Centre, Guy's and St. Thomas' Hospital, London, United Kingdom.
Multidisciplinary Pain Centre, AZ Nikolaas, St Niklaas, Belgium.
Ann N Y Acad Sci. 2020 Feb;1462(1):53-64. doi: 10.1111/nyas.14236. Epub 2019 Oct 2.
Chronic pain is a common condition that affects the physical, emotional, and mental well-being of patients and can significantly diminish their quality of life. Due to growing concerns about the substantial risks of long-term opioid use, both governmental agencies and professional societies have recommended prioritizing the use of nonpharmacologic treatments, when suitable, in order to reduce or eliminate the need for opioid use. The use of 10 kHz spinal cord stimulation (10 kHz SCS) is one such nonpharmacologic alternative for the treatment of chronic, intractable pain of the trunk and limbs. This review examines published clinical data regarding the efficacy of 10 kHz SCS for decreasing chronic pain in patients and its potential to reduce or eliminate opioid usage. Multiple prospective and retrospective studies in patients with intractable pain demonstrated that 10 kHz SCS treatment provided ≥50% pain relief in >70% patients after at least 1 year of treatment. Pain relief with 10 kHz SCS therapy ranged from 54% to 87% in the studies. More importantly, the mean daily dose of opioids required by patients in these studies was reduced after 10 kHz SCS treatment, and on average over 60% patients in studies either reduced or eliminated opioids at the last follow-up.
慢性疼痛是一种常见病症,影响着患者的身体、情感和心理健康,大大降低了他们的生活质量。由于对长期使用阿片类药物的巨大风险的日益关注,政府机构和专业协会都建议优先使用非药物治疗方法,在合适的情况下,以减少或消除对阿片类药物的使用需求。使用 10kHz 脊髓刺激(10kHz SCS)就是治疗躯干和四肢慢性、顽固性疼痛的一种非药物替代方法。这篇综述考察了已发表的临床数据,评估了 10kHz SCS 治疗慢性疼痛的疗效及其减少或消除阿片类药物使用的潜力。多项针对难治性疼痛患者的前瞻性和回顾性研究表明,至少 1 年的治疗后,10kHz SCS 治疗使超过 70%的患者的疼痛缓解程度达到≥50%。这些研究中的疼痛缓解率在 54%至 87%之间。更重要的是,这些研究中的患者在接受 10kHz SCS 治疗后,所需的阿片类药物日平均剂量减少,而且在研究的最后随访中,平均有超过 60%的患者减少或停止使用阿片类药物。