BackgroundSacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode (InterStim®, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration.MethodsWe present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary.ResultsOur experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration.ConclusionsThe caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

Objective: The use of drugs with different mechanisms, in combination for the treatment of pain, particularly acute postoperative pain, is a main part of the multimodal analgesia. The aim of this study was to evaluate the ef cacy of metamizol plus paracetamol and compare it with the association of paracetamol plus dexketoprofen in acute postoperative pain. Methods: We designed a prospective interventional study that included 42 patients undergoing general anesthesia for probably low algesic and duration of surgery < 120 minutes. All were treated with one grame of intraoperative paracetamol and then, in the resuscitation unit, when the score on the simple numeric scale was > 3, they received the drug of the group that they were assigned (metamizol: group M; dexketoprofen: group D), with evaluation of variations in the scale score. We examined in both groups demographic variables, variables related to anesthesia and surgery, simple numeric scale (NSE) changes, complications and the incidents during the process. Results: 20 patients were studied in the M group and 22 patients in D group. Both groups had a similar distribution in terms of demographic variables, medical history, type and duration of surgery. Both group showed a clinically relevant decrease in the score of the simple numeric scale (p < 0.05). No differences were in the decrease of NSE when we compared the two groups together (p > 0.05). Conclusion: Our results suggest that the combination of paracetamol plus metamizol in combined therapy for management of acute postoperative pain is effective and comparable to the combination of paracetamol plus dexketoprofen and can constitute an alternative therapy.

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