[耳迷走神经刺激治疗慢性和急性疼痛的临床疗效:系统性综述]。

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY
Schmerz Pub Date : 2024-08-01 Epub Date: 2023-01-02 DOI:10.1007/s00482-022-00686-2
Rudolf Likar, Christophe Perruchoud, Stefan Kampusch, Markus Köstenberger, Sabine Sator, Caroline Stremnitzer, Andreas Wolf, Stefan Neuwersch-Sommeregger
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引用次数: 0

摘要

背景:现行指南建议采用个性化、多模式和跨学科的方法治疗慢性疼痛。在术后疼痛的急性治疗中,最大限度地减少慢性化的风险因素是非常有用的。耳迷走神经刺激疗法(aVNS)是治疗慢性和急性疼痛的一种有效的非药物疗法:本系统综述旨在评估耳迷走神经刺激疗法对慢性和急性疼痛的临床疗效及其对药物摄入的影响:对耳穴电刺激在慢性和急性疼痛中的应用进行了系统性文献检索。根据证据级别对研究进行分类,并通过 Jadad 量表对其科学性和有效性进行评估,然后从适应症、方法、刺激参数、治疗持续时间、疗效和安全性等方面进行分析:结果:共发现并分析了 20 项关于慢性疼痛适应症的研究、10 项关于急性术后疼痛的研究以及 7 项关于实验性急性疼痛的研究。搜索结果显示,共有 n = 1105 名接受过 aVNS 治疗的患者。有关 aVNS 疗效的最佳证据包括慢性腰背痛、慢性颈椎综合征、慢性腹痛、慢性偏头痛以及卵母细胞抽吸术、腹腔镜肾切除术和开腹结肠直肠手术中的急性术后疼痛。此外,在大多数研究中,镇痛剂或阿片类药物的摄入量明显减少。在三项针对慢性疼痛患者的随机对照试验中,疼痛持续减轻的时间长达 12 个月。总体而言,aVNS 的耐受性非常好:本综述表明,对慢性和急性术后疼痛患者而言,aVNS 是一种补充性的、有效的非药物治疗方法。未来针对这些适应症的研究应重点关注治疗参数的标准化和优化、生活质量结果参数的纳入以及更长的随访期,以更好地了解 aVNS 的可持续治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Clinical efficacy of auricular vagus nerve stimulation in the treatment of chronic and acute pain : A systematic review].

Background: Current guidelines recommend a personalized, multimodal, and interdisciplinary approach for the treatment of chronic pain. Already in the acute treatment of postoperative pain, it can be useful to minimize risk factors for chronification. Auricular vagus nerve stimulation (aVNS) could be an effective non-drug therapy for the treatment of chronic and acute pain.

Aim of the work: The aim of this systematic review is to evaluate the clinical efficacy of aVNS in chronic and acute pain as well as its effect on medication intake.

Materials and methods: A systematic literature search was carried out on the application of auricular electrical stimulation in chronic and acute pain. Studies were classified according to their level of evidence and evaluated via the Jadad scale as well as their scientific validity, and then analyzed in terms of indication, method, stimulation parameters, duration of treatment, efficacy, and safety.

Results: Twenty studies on chronic pain indications, ten studies on acute postoperative pain, as well as seven studies on experimental acute pain were identified and analyzed. The search revealed a total of n = 1105 aVNS-treated patients. The best evidence on the efficacy of aVNS is available for the indications chronic low back pain, chronic cervical syndrome, chronic abdominal pain, and chronic migraine as well as acute postoperative pain in oocyte aspiration, laparoscopic nephrectomy, and open colorectal surgery. Additionally a significant reduction in analgesic or opiate intake was evident in most studies. In three randomized controlled trials in chronic pain patients, a sustainable pain reduction over a period of up to 12 months was shown. Overall, aVNS was very well tolerated.

Conclusion: This review indicates that aVNS can be a complementary and effective non-drug treatment for patients with chronic and acute postoperative pain. Future studies in these indications should focus on standardizing and optimizing treatment parameters, inclusion of quality-of-life outcome parameters, and longer follow-up periods to better understand the sustainable therapeutic effect of aVNS.

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来源期刊
Schmerz
Schmerz 医学-临床神经学
CiteScore
2.00
自引率
20.00%
发文量
64
审稿时长
6-12 weeks
期刊介绍: Der Schmerz is an internationally recognized journal and addresses all scientists, practitioners and psychologists, dealing with the treatment of pain patients or working in pain research. The aim of the journal is to enhance the treatment of pain patients in the long run. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of pain research, pain management and pain symptom management. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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