Neuromodulation for Pain Management in the Inpatient Setting: A Narrative Review

Abd‐Elsayed, Alaa; Tang, Tuan; Karri, Jay; Hughes, Maria Celia; Urits, Ivan; Gupta, Mayank; Pasqualucci, Alberto; Myrcik, Dariusz; Varrassi, Giustino; Viswanath, Omar

doi:10.7759/cureus.13892

Cited by 5 publications

(3 citation statements)

References 71 publications

(111 reference statements)

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“…This pilot survey demonstrated an overall satisfaction rate of 97% and an average pain reduction of 3.47. This is in line with previous studies of noninvasive high frequency neuromodulation [16]. Our study was able to provide a strong correlation with all metrics.…”

Section: Discussionsupporting

confidence: 92%

“…We performed an open-label pilot study intended to add strength and depth to the current research of noninvasive burst neuromodulation effectiveness in people with chronic pain. A previous study of 463 individuals who were surveyed after 2 weeks of noninvasive neuromodulation therapy showed an average pain reduction of 3.05 points on a Numeric Pain Scale (NPS) [16]. This prompted follow-up studies with larger power to assess the efficacy of noninvasive neuromodulation therapy as a promising, safe, and cost-effective treatment modality.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Pain and Improved Function Following Short-Term Use of Noninvasive BioWave High Frequency Peripheral Nerve Stimulation for Pain Management

et al. 2023

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Introduction: The peripheral nervous system is an increasingly popular target for chronic pain treatment modalities. Noninvasive neuromodulation has shown promise at providing significant chronic pain relief with a much safer side effect profile. This retrospective pilot study is shaped around a noninvasive neuromodulation system over a 2-week treatment timeline. Methods: Open-label survey of chronic pain patients recruited from Veteran Affairs, orthopedic, and pain health systems. If a noninvasive neuromodulation system was prescribed the patients were then offered a 2-week follow-up survey. This voluntary survey did not affect their therapy duration or quality. This survey was designed to address similar metrics as smaller noninvasive neuromodulation studies to allow a quality comparison while giving more power with a large population size of 1511 patients. Overall pain scores (including before and after scores), satisfaction level, desire to continue therapy, medication use, effect on functional metrics (mood, sleep, sit, stand, walk, and lift), and activities of daily living (ADL) scores were assessed. Results: The results demonstrated an overall pain reduction of 46%. All functional metrics were improved throughout with the largest improvements reported in mood and sleep at over 47%. Medication use was reported as decreased or eliminated in 42% of patients. There were no adverse reactions or complications reported over the 1511 patients. Conclusion: This survey is amongst the largest population sizes every studied for noninvasive neuromodulation. Within just 2 weeks patients can see a reduction in overall pain and medication needs. Although survey studies have inherent limitations such as duration and compliance biases with such an overwhelming benefit in every category we believe that noninvasive neuromodulation therapy is a promising, safe, and cost-effective therapy. Future studies should focus on long-term follow-ups

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Reduced Pain and Improved Function Following Short-Term Use of Noninvasive BioWave High Frequency Peripheral Nerve Stimulation for Pain Management

et al. 2023

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“…In this context, the effects of SARS-COV-2 infection on patients affected by RP are still under study. Even if neuromodulation, in general, seems beneficial in many pain syndromes [21], the interplay between the action of SCS in restoring perfusion on one side and the pro-inflammatory and procoagulant effect on micro and macrovasculature of the virus on the other is largely unknown.…”

Section: Discussionmentioning

confidence: 99%

Successful Spinal Cord Stimulation for Necrotizing Raynaud’s Phenomenon in COVID-19 Affected Patient: The Nightmare Comes Back

Giglio¹,

Preziosa²,

Rekatsina³

et al. 2021

Cureus

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Necrotizing Raynaud's phenomenon is a vascular clinical syndrome characterized by vasospasm of distal resistance vessels, usually triggered by cold temperatures or by psychological conditions such as anxiety and stress. Pain is the first reported symptom, related to insufficient oxygen delivery to the extremities that leads to ischemia of the peripheral tissues. The initial treatment is conservative, but if the symptoms persist, necrosis and distal amputation can occur. In selected patients, neuromodulation with spinal cord stimulation (SCS) can be an effective treatment by reducing pain and amputation rate. Recent evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause endotheliopathy with microvascular and macrovascular thrombotic events and can present as a systemic inflammatory vascular disease.We present a case of a severe necrotizing Raynaud's phenomenon successfully treated and controlled with SCS that abruptly reappeared during SARS-CoV-2 infection.The report of this case is suggestive for potential treatment in case of peripheral ischemia consequent to COVID-19 vasculopathy. The interaction between SCS and SARS-CoV-2-related endotheliopathy is unknown and would deserve further studies.

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The study of nurses’ knowledge and attitudes regarding pain management and control in emergency departments

2023

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Background Given the importance and pivotal role of nurses in pain management and control, this study was conducted to determine the nurses’ knowledge and attitudes toward in emergency departments. Methods This study was designed and conducted as a descriptive-analytical cross-sectional study. Nurses’ attitude and knowledge towards pain management and control and relationship between their demographic characteristics have been assessed. Nurse Attitude Survey (NAS) and Pain management and control principles assessment Test (PMPAT) questionnaires were used. Results Totally 400 volunteers, including 148 (37.2%) male and 250 (62.8%) female nurses recruited from 23 hospitals in East Azerbaijan, Iran, with a mean age of 30.88 years (± 6.04 SD) and age range between 22 and 53 years old. The crude mean score of participants’ knowledge of pain management and control was 12.51 (± 2.77 SD), and standardized mean score was 40.34 (± 8.92 SD), which was low at 84.8% and moderate in 15.3% of the participants. Older nurses and nurses who previously participated in pain retraining courses had significantly less knowledge about pain management and control (r= -0.104, P = 0.038), and (r= -0.148, P = 0.003) respectively. The crude mean score of participants’ attitudes toward pain control and management was 15.22 (± 2.56 SD), and standardized mean score was 60.87 (± 10.26 SD). Nurses’ attitudes have become more negative with the increase of their work experience (r = -0.168, P = 0.001), and previously participation in pain retraining courses (r =-0.207, P < 0.001). Older nurses and highly educated nurses had significantly more negative attitudes towards pain control and management (r = -0.153, P = 0.002), and (r= -0.126, P = 0.005), respectively. Conclusions The current study revealed that pain management and control knowledge in most emergency nurses was low, and most of them had a moderate attitude. We need more scientific and comprehensive pain management and control training courses to improve knowledge and attitude among health workers and nurses.

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Neuromodulation for Pain Management in the Inpatient Setting: A Narrative Review

Abstract: Abd-Elsayed et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 5 publications

References 71 publications

Reduced Pain and Improved Function Following Short-Term Use of Noninvasive BioWave High Frequency Peripheral Nerve Stimulation for Pain Management

Reduced Pain and Improved Function Following Short-Term Use of Noninvasive BioWave High Frequency Peripheral Nerve Stimulation for Pain Management

Successful Spinal Cord Stimulation for Necrotizing Raynaud’s Phenomenon in COVID-19 Affected Patient: The Nightmare Comes Back

The study of nurses’ knowledge and attitudes regarding pain management and control in emergency departments

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