Postoperative Analgesic Effect of Transcranial Direct Current Stimulation in Lumbar Spine Surgery

Autor: Michel Ossemann, Maximilien Gourdin, Jacques Jamart, Pascale De Bue, Yves Vandermeeren, Philippe Dubois, Katalin de Fays
Rok vydání: 2013
Předmět:
Adult
Male
Analgesic effect
Adolescent
medicine.medical_treatment
Pain
Electric Stimulation Therapy
Context (language use)
Patient-Controlled
Opioid
Research Support
medicine.disease_cause
law.invention
Outcome Assessment (Health Care)
Young Adult
Double-Blind Method
Randomized controlled trial
law
Outcome Assessment
Health Care
80 and over
Journal Article
medicine
Humans
Postoperative
Non-U.S. Gov't
Aged
Pain Measurement
Aged
80 and over
Analgesics
Pain
Postoperative
Morphine
Transcranial direct-current stimulation
business.industry
Gastric bypass surgery
Lumbosacral Region
Analgesia
Patient-Controlled
Middle Aged
Analgesics
Opioid
Transcranial magnetic stimulation
Anesthesiology and Pain Medicine
Anesthesia
Brain stimulation
Randomized Controlled Trial
Female
Neurology (clinical)
Analgesia
business
medicine.drug
Zdroj: The Clinical Journal of Pain. 29:696-701
ISSN: 0749-8047
Popis: BACKGROUND: Ultimately, the experience of pain derives from changes in brain excitability. Therefore, modulating the excitability of cortical areas involved in pain processing may become an attractive option in the context of multimodal analgesia during the postoperative period. Repetitive transcranial magnetic stimulation (rTMS) can reduce morphine consumption during the postoperative period after gastric bypass surgery. We tested the potential of another method of noninvasive brain stimulation, transcranial direct current stimulation (tDCS), to reduce morphine consumption or pain perception during the postoperative period.METHODS: Fifty-nine ASA I to II patients undergoing lumbar spine surgery were randomized to receive anodal (n=20), cathodal (n=20), or sham (n=19) tDCS in the recovery room in a double-blind manner. Morphine consumption administrated through patient-controlled analgesia (PCA) was the primary outcome; pain perception as measured by visual analog scale was the secondary outcome.RESULTS: There were no statistically significant differences between the 3 groups of patients, either for PCA morphine consumption or for pain scores.CONCLUSIONS: Several factors may explain the observed lack of impact of tDCS on PCA morphine consumption and pain perception: the method of brain stimulation (tDCS/rTMS), potential interactions with anesthetic drugs, differences in patients population (gastric bypass surgery/lumbar spine surgery), and the previous experience of pain and chronic consumption of analgesic drugs. Further studies with tDCS should be performed before concluding that tDCS is inefficient for postoperative pain control, because noninvasive brain stimulation methods, such as rTMS and tDCS, may become attractive in the setting of multimodal analgesia.
Databáze: OpenAIRE
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