评估胸交感神经节阻滞对慢性上肢疼痛患者氯胺酮输注疗法和脊髓刺激反应的预测作用。

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY
Pain Medicine Pub Date : 2024-09-01 DOI:10.1093/pm/pnae038
Jeongsoo Kim, Hangaram Kim, Jae Eun Kim, Yongjae Yoo, Jee Youn Moon
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引用次数: 0

摘要

目的研究胸交感神经节阻滞(TSGB)对慢性上肢疼痛(包括复杂区域疼痛综合征(CRPS))患者氯胺酮输注疗法(KIT)和脊髓刺激(SCS)反应的预测价值:设计:回顾性:受试者:接受TSGB治疗并接受KIT和脊髓刺激(SCS)治疗的患者:方法:TSGB 阳性结果的定义是,患者在接受 KIT 或 SCS 治疗的 3 年时间内,TSGB 的治疗效果良好:TSGB阳性结果定义为术后2周0-10分数值评定量表(NRS)评分减少≥2分。KIT 和 SCS 阳性结果分别以 KIT 术后 2-4 周 NRS 评分降低≥2 分和 SCS 植入术后 2-4 周 NRS 评分降低≥4 分来确定:在207例接受TSGB的患者中,38例接受了KIT,34例在TSGB术后3年内接受了SCS植入;其中33例接受KIT,32例接受SCS。在接受 KIT 的 33 名患者中,60.6%(n = 20)报告 0-10 NRS 疼痛评分降低≥2 分。70.0%(n = 14)的 KIT 反应者对 TSGB 有积极反应,明显高于 30.8%(n = 4)的 KIT 无反应者。多变量分析显示,TSGB 阳性反应与 KIT 呈正相关(OR 7.004,95% CI 1.26-39.02)。在接受 SCS 植入的 32 名患者中,68.8%(n = 22)的患者获得了短期疗效。对 TSGB 有积极反应的 SCS 反应者(45.5%,n = 10)明显高于无反应者(0.0%)。然而,TSGB术后疼痛减轻与KIT术后或SCS术后疼痛减轻之间没有关联:结论:TSGB的阳性反应是慢性上肢疼痛(包括CRPS)患者KIT和SCS阳性结果的潜在预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of thoracic sympathetic ganglion block as a predictor for response to ketamine infusion therapy and spinal cord stimulation in patients with chronic upper extremity pain.

Objective: To investigate the predictive value of thoracic sympathetic ganglion block (TSGB) in response to ketamine infusion therapy (KIT) and spinal-cord stimulation (SCS) in patients with chronic upper-extremity pain including complex regional pain syndrome (CRPS).

Design: Retrospective.

Setting: Tertiary hospital single-center.

Subjects: Patients who underwent TSGB receiving KIT or SCS within a 3-year window.

Methods: Positive TSGB outcomes were defined as ≥2 0-10 Numerical Rating Scale (NRS) score reduction at 2 weeks post-procedure. Positive KIT and SCS outcomes were determined by ≥2 NRS score reduction at 2-4 weeks post-KIT and ≥4 NRS score reduction at 2-4 weeks post-SCS implantation, respectively.

Results: Among 207 patients who underwent TSGB, 38 received KIT and 34 underwent SCS implantation within 3 years post-TSGB; 33 patients receiving KIT and 32 patients receiving SCS were included. Among 33 patients who received KIT, 60.6% (n = 20) reported a ≥ 2 0-10 NRS pain-score reduction. Positive response to TSGB occurred in 70.0% (n = 14) KIT responders, significantly higher than that in 30.8% (n = 4) KIT non-responders. Multivariable analysis revealed a positive association between positive responses to TSGB and KIT (OR 7.004, 95% CI 1.26-39.02). Among 32 patients who underwent SCS implantation, 68.8% (n = 22) experienced short-term effectiveness. Positive response to TSGB was significantly higher in SCS responders (45.5%, n = 10) than in non-responders (0.0%). However, there were no associations between pain reduction post-TSGB and that post-KIT or post-SCS.

Conclusions: A positive response to TSGB is a potential predictor for positive KIT and SCS outcomes among patients with chronic upper-extremity pain, including CRPS.

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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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