脊髓神经刺激器植入后阿片类药物治疗难治性慢性疼痛综合征的消退:病例报告

Aleksandra V. Burmistrova, A. Vorobyev, M. Varyukhina, Anna A. Ilina, M. Radutnaya, A. Yakovlev, A. Grechko
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引用次数: 0

摘要

背景:癌症患者的疼痛,往往治疗不当,给患者和他们的照顾者造成严重的痛苦,并显著降低生活质量。癌症患者慢性疼痛的现代医学治疗指南并非对所有病例都有效,特别是当发生慢性神经性疼痛综合征时。在这方面,需要多学科的个性化方法来治疗慢性疼痛,而不是在这种情况的早期阶段采用手术方法。目前,神经调节被广泛应用于各种病理的神经性慢性疼痛综合征的治疗,而在癌症患者中却没有常规应用。临床病例描述:我们介绍一个成功应用神经调节治疗直肠癌所致严重慢性疼痛综合征的病例报告。th10 - th12水平的硬膜外脊髓刺激允许停止阿片类药物的全身使用并实现长期缓解。脊髓刺激已被证明是非常有前途的,并显著改善了患者的生活质量。结论:我们的病例报告清楚地表明,目前的慢性疼痛管理指南和治疗建议需要修订,应考虑在癌症患者类别中使用神经调节剂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Regression of chronic pain syndrome refractory to opioid pharmacotherapy in a patient after implantation of a spinal cord neurostimulator: case report
BACKGROUND: Pain in cancer patients, often poorly treated, cause severe distress for patients and their caregivers, and significantly reduces quality of life. Modern guides for the medical treatment of chronic pain in cancer patients are not effective in all cases, especially when chronic neuropathic pain syndrome occurs. In this regard, there is a need for a multidisciplinary personalized approach to the tactics of chronic pain management in favor of surgical methods at earlier stages of this condition. Nowadays neuromodulation is widely used for the treatment of neuropathic chronic pain syndrome in patients with various pathologies, whereas it is not used routinely in cancer patients. CLINICAL CASE DESCRIPTION: We introduce a case report of successfully applied neuromodulation in patient with severe chronic pain syndrome due to rectal cancer. Epidural spinal cord stimulation at Th10Th12 levels allowed to stop the systemic use of opioids and achieve long-term remission. Spinal cord stimulation has shown itself to be very promising and significantly improved patients quality of life. CONCLUSIONS: Our case report evidently shows that current chronic pain management guides and treatment recommendations needs a revision and neuromodulation usage in category of cancer patients should be considered.
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