Standardisierung invasiver neuromodulativer Verfahren

Abstract

The Working Group on Neuromodulation of the German Association for the Study of Pain, composed of representatives from various scientific specialty societies, met on December 9, 2000, March 24, 2001, October 5, 2001, and December 8, 2001. As a result of these discussions grounded in current knowledge, the following guidelines were formulated for the standardization of invasive techniques of neuromodulation intended to serve as a systematic aid in decision-making and to provide recommendations for practice-oriented methods. The guidelines were based on both the clinical and practical experience of the group participants (see information box on the next page) as well as on the current scientific literature and guidance from the consensus report of the European Federation of IASP Chapters (EFIC) [23]. The guidelines serve the purpose of orientation and have no effect on either assumption of liability or discharge from liability. The guidelines were conceived for use by physicians in private practice,doctors in hospitals,and nonmedical personnel concerned with the care of chronic pain patients. The Working Group consists of unsalaried volunteers. The participants received no honorarium and were only reimbursed for normal travel expenses in accordance with customary directives. The guidelines will be revised should new scientific results become available, at the latest in 2 years. The plan exists to further develop the guidelines to stages II and III (AWMF). The Steering Committee of the DGSS appraised the guidelines and authorized the guidelines before publication.

Analgesic and antinociceptive effects of peripheral nerve neurostimulation in an advanced human experimental model

“…Whereas neuromodulation has been applied for decades, its antinociceptive efficacy in man is still under debate (Canavero and Bonicalzi, 2003; Eisenberg et al, 2004; Eisenberg and Brecker, 2002; Gybels et al, 1998; Harke et al, 2003; Maier and Zenz, 2003; Mailis‐Gagnon et al, 2004). This controversial discussion is mainly due to the lack of appropriate experimental studies addressing objective effects of neuromodulatory stimulation of tactile afferents on nociception and pain.…”

Epidurale Rückenmarkstimulation zur Therapie chronischer Schmerzen

“…Basierend auf der publizierten S1-Leitlinie [11] wurden die Fachgesellschaften, die sich entweder mit der Methode der epiduralen Rückenmark-stimulation oder den damit therapierten Krankheitsbildern befassen, um die Entsendung eines Fachvertreters in die Arbeitsgruppe gebeten. Entscheidend für die Formulierung einer S3-Leitlinien nach dem Stufenkonzept der Arbeitsgemeinschaft wissenschaftlicher medizinischer Fachgesellschaften war ein formaler Konsensusfindungsprozess aus nominalem Gruppenprozess, Konsensuskonferenz und letztlich Delphiverfahren in den jeweiligen Fachgesellschaften und der Patientenorganisation.…”

Ausgewählte interventionelle Verfahren zur Behandlung chronischer Schmerzen

“…Die Testung ist als positiv zu werten, wenn eine Schmerzreduktion um mindestens 50%, eine Verminderung des Medikamentenverbrauchs und eine Verbesserung der Lebensqualität erreicht werden. Die Ergebnisse sollten sorgfältig dokumentiert werden [13,24].…”