Chronic Neuropathic Pain Therapy and Anaesthesia

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 10274

Special Issue Editor


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Guest Editor
Institute of Medicine, University of Opole, 45-040 Opole, Poland
Interests: spinal surgery; neurosurgery; neuroscience

Special Issue Information

Dear Colleagues,

Despite considerable advances in our understanding of the mechanism of neuropathic pain, it remains a serious, global public health issue. Regardless of the etiology, it often has a profoundly devastating effect on an individual’s quality of life. Medical treatment is a mainstay of therapy, with many medications being used off-label due to a lack of better options.

In this Special Issue, we welcome original research papers and review articles concerned with this important clinical entity. We want this to be a comprehensive update on recent advances in the field of management of neuropathic pain, with emphasis on various methods of treatment.

Dr. Grzegorz Miękisiak
Guest Editor

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Keywords

  • chronic neuropathic pain
  • medical treatment
  • prevention
  • therapy
  • neuropathy
  • peripheral nerve injury

Published Papers (7 papers)

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Editorial

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3 pages, 248 KiB  
Editorial
Editorial for the Special Issue “Chronic Neuropathic Pain Therapy and Anaesthesia”
by Grzegorz Miękisiak
Medicina 2023, 59(4), 674; https://doi.org/10.3390/medicina59040674 - 29 Mar 2023
Viewed by 996
Abstract
Chronic neuropathic pain (CNP), a complex and debilitating condition arising from damage or dysfunction of the somatosensory nervous system, affects millions of people worldwide [...] Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)

Research

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9 pages, 895 KiB  
Article
Evaluation of Patient’s Quality of Life before and after Implantation of Abbott’s Proclaim™ XR Spinal Cord Stimulator with BurstDR™ Stimulation in Chronic Pain Syndrome
by Wojciech Tomasz Ślusarczyk, Tadeusz Jerzy Nejman, Maciej Laskowski, Agnieszka Koperczak, Agnieszka Stanuszek and Marcin Ciekalski
Medicina 2023, 59(12), 2192; https://doi.org/10.3390/medicina59122192 - 17 Dec 2023
Viewed by 944
Abstract
Background and Objectives: In case of the ineffectiveness of pharmacological and non-pharmacological treatments in managing chronic neuropathic pain, spinal cord stimulation (SCS) with BurstDR™ stimulation may reduce pain and increase the quality of life. The term “burst” refers to a series of stimulation [...] Read more.
Background and Objectives: In case of the ineffectiveness of pharmacological and non-pharmacological treatments in managing chronic neuropathic pain, spinal cord stimulation (SCS) with BurstDR™ stimulation may reduce pain and increase the quality of life. The term “burst” refers to a series of stimulation impulses that are compressed into small packets and separated by intervals of latency. Materials and Methods: A group of 30 consecutive patients who received the BurstDR™ stimulator using the minimally invasive percutaneous method was selected. Patients selected for our study underwent numerous spinal surgeries before SCS implantation. In the study, analgesics and co-analgesics and their doses used by patients before and 6 months after SCS implantation were examined and compared. Using the visual analogue scale (VAS), pain was compared before and after the procedure. Patients` quality of life was assessed using the Oswestry Disability Index (ODI). Results: We observed a significant reduction in opioid daily doses by an average of 32.4% (±36.1%) and a reduction in paracetamol daily doses by an average of 40% (±33.4%). There was a reduction in pregabalin doses as well. Ketoprofen daily dose reduction was 85.4 mg. The mean VAS difference before and after procedure was 3.9 (±2.3), and the mean difference in ODI was 12.9 (±9), which benefits operative treatment. The VAS and ODI results were statistically significant as well. Conclusions: According to our research, BurstDR™ stimulation improves the quality of life by reducing doses of analgesics and the level of pain. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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10 pages, 613 KiB  
Article
Impact of Sarcopenia on Percutaneous Epidural Balloon Neuroplasty in Patients with Lumbar Spinal Stenosis: A Retrospective Analysis
by Yun-A Han, Hyun-Jung Kwon, Kunhee Lee, Min-Gi Son, Hotaek Kim, Seong-Soo Choi, Jin-Woo Shin and Doo-Hwan Kim
Medicina 2023, 59(5), 847; https://doi.org/10.3390/medicina59050847 - 27 Apr 2023
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Abstract
Background and Objectives: With the aging population, the incidence of degenerative lumbar spinal stenosis (LSS) is increasing. Sarcopenia is an age-related muscular decrease. Although epidural balloon neuroplasty is effective in patients with LSS refractory to conventional treatments, its effect has not been [...] Read more.
Background and Objectives: With the aging population, the incidence of degenerative lumbar spinal stenosis (LSS) is increasing. Sarcopenia is an age-related muscular decrease. Although epidural balloon neuroplasty is effective in patients with LSS refractory to conventional treatments, its effect has not been assessed in patients with sarcopenia. Therefore, this study evaluated the effect of epidural balloon neuroplasty in patients with LSS and sarcopenia. Materials and Methods: This retrospective study reviewed the following details from the electronic medical records: patient characteristics, including sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications. Back and leg pain intensity was evaluated before and after the procedure at one, three, and six months during the follow-up period. A generalized estimating equations model was used at six months follow-up. Patients were divided into sarcopenia and non-sarcopenia groups using the cross-sectional area of the psoas muscle at the level of L3 on magnetic resonance imaging. Results: A total of 477 patients were included (sarcopenia group: 314 patients, 65.8%; non-sarcopenia group: 163 patients, 34.2%). Age, sex, body mass index, and medication quantification scale III were statistically different between both groups. The generalized estimating equations analyses—with unadjusted and adjusted estimation—revealed a significantly reduced pain intensity after the procedure compared to the baseline in both groups. The difference in pain intensity between both groups was not statistically different. Conclusions: Percutaneous epidural balloon neuroplasty may be considered for patients with chronic lumbar LSS regardless of accompanying sarcopenia. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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9 pages, 575 KiB  
Article
A Pilot Study of Autonomic Function Screening Tests for Differentiating Complex Regional Pain Syndrome Type II and Traumatic Neuropathic Pain
by Dayoung Kim, Min Jung Kim, Jae Hun Kim, Jeeyoung Oh and Kyomin Choi
Medicina 2023, 59(4), 646; https://doi.org/10.3390/medicina59040646 - 24 Mar 2023
Cited by 3 | Viewed by 1254
Abstract
Background and Objectives: One of the most challenging tasks in a clinical setting is to differentiate between complex regional pain syndrome (CRPS) type II and traumatic neuropathic pain (NeP). CRPS is characterized by several dysautonomic manifestations, such as edema, hyper/hypohidrosis, skin color change, [...] Read more.
Background and Objectives: One of the most challenging tasks in a clinical setting is to differentiate between complex regional pain syndrome (CRPS) type II and traumatic neuropathic pain (NeP). CRPS is characterized by several dysautonomic manifestations, such as edema, hyper/hypohidrosis, skin color change, and tachycardia. This study compared the outcomes of autonomic function screening tests in patients with CRPS type II and traumatic NeP for diagnostic differentiation. Materials and Methods: CRPS type II was diagnosed according to the Budapest research criteria, while NeP was diagnosed according to the updated grading system suggested by the International Association for the Study of Pain Special Interest Group on Neuropathic Pain in 2016. Twenty patients with CRPS type II and twenty-five with traumatic NeP were investigated. Results: Twelve patients with CRPS type II presented abnormal results for the quantitative sudomotor axon reflex test (QSART). Abnormal QSART results were more common in the CRPS type II group. Conclusions: Analysis of QSART combined with other ancillary tests can help in the differential diagnosis of CRPS type II and traumatic NeP if factors influencing abnormal QSART are sufficiently controlled. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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Review

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17 pages, 2566 KiB  
Review
Failed Back Surgery Syndrome: No Longer a Surgeon’s Defeat—A Narrative Review
by Grzegorz Miękisiak
Medicina 2023, 59(7), 1255; https://doi.org/10.3390/medicina59071255 - 06 Jul 2023
Cited by 2 | Viewed by 3031
Abstract
The introduction of the term Persistent Spinal Pain Syndrome (PSPS-T1/2), replacing the older term Failed Back Surgery Syndrome (FBSS), has significantly influenced our approach to diagnosing and treating post-surgical spinal pain. This comprehensive review discusses this change and its effects on patient care. [...] Read more.
The introduction of the term Persistent Spinal Pain Syndrome (PSPS-T1/2), replacing the older term Failed Back Surgery Syndrome (FBSS), has significantly influenced our approach to diagnosing and treating post-surgical spinal pain. This comprehensive review discusses this change and its effects on patient care. Various diagnostic methods are employed to elucidate the underlying causes of back pain, and this information is critical in guiding treatment decisions. The management of PSPS-T1/2 involves both causative treatments, which directly address the root cause of pain, and symptomatic treatments, which focus on managing the symptoms of pain and improving overall function. The importance of a multidisciplinary and holistic approach is emphasized in the treatment of PSPS-T1/2. This approach is patient-centered and treatment plans are customized to individual patient needs and circumstances. The review concludes with a reflection on the impact of the new PSPS nomenclature on the perception and management of post-surgical spinal pain. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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Other

7 pages, 1977 KiB  
Case Report
Successful Ultrasound-Guided Superficial Cervical Plexus Block Treatment for Head and Neck Pain with an Unusually Delayed Onset Following Ventriculoperitoneal Shunt: A Case Report
by Ching-Yuan Hu, Ying-Zhen Huang, Sheng-Tzung Tsai and Po-Kai Wang
Medicina 2023, 59(11), 1909; https://doi.org/10.3390/medicina59111909 - 28 Oct 2023
Viewed by 962
Abstract
Background and Objectives: Ventriculoperitoneal (VP) shunt placement is the most common treatment for cerebrospinal fluid diversion. Head and neck pain occurring after a long period following VP shunt insertion is rarely reported. Here, we present a rare case of head and neck pain [...] Read more.
Background and Objectives: Ventriculoperitoneal (VP) shunt placement is the most common treatment for cerebrospinal fluid diversion. Head and neck pain occurring after a long period following VP shunt insertion is rarely reported. Here, we present a rare case of head and neck pain occurring 2 years after surgery due to irritation of the superficial cervical plexus by the VP shunt. Case Description: A 46-year-old female patient received VP shunt placement surgery. Two years after the surgery, she experienced a left temporal headache with neck pain on the left side, which extended to the left para-auricular and fascial region. Ultrasound (US) scanning revealed that the VP shunt passed within the superficial cervical fascia and through the left sternocleidomastoid muscle (SCM). Additionally, friction of the branches of the superficial cervical plexus and of the greater auricular and lesser occipital nerves caused by the VP shunt was found underneath the lateral border of the SCM. Subsequently, the blocking and hydro-release of the left superficial cervical plexus were performed. After four series of treatments, the patient’s head and neck pain vanished, and the frequency of the headaches was substantially reduced. The patient was regularly followed-up in the outpatient department of neurosurgery. Conclusions: Head and neck pain caused by the malpositioning of a VP shunt catheter with an unusually delayed onset is a rarely reported complication and could be easily neglected. Patients with head and neck pain following VP shunt insertion should be checked using US scanning to identify the potential origin of the pain and receive adequate treatments. Intraoperative US-guided tunnelling is suggested to avoid the malpositioning of the VP shunt catheter. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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6 pages, 948 KiB  
Case Report
Longitudinal Change in Brain Functional Connectivity with Herpes Zoster Patients: Neuroimaging Case Series
by Changjae Kim, Joongbaek Kim, Hyunjae Chang, Dakyung Hong, Sanghyun Hong and Hosik Moon
Medicina 2023, 59(6), 1045; https://doi.org/10.3390/medicina59061045 - 29 May 2023
Viewed by 999
Abstract
The exact mechanism involved in the development of postherpetic neuralgia (PHN) is not yet known. The objective of this study was to evaluate longitudinal functional connectivity (FC) changes in the neuroimaging case series of patients with acute herpes zoster (HZ). Cases: This study [...] Read more.
The exact mechanism involved in the development of postherpetic neuralgia (PHN) is not yet known. The objective of this study was to evaluate longitudinal functional connectivity (FC) changes in the neuroimaging case series of patients with acute herpes zoster (HZ). Cases: This study included five patients who had symptoms of HZ. Functional magnetic resonance imaging was conducted at enrollment and 3 months to determine FC changes. Of the five patients, three developed PHN. In the PHN subjects, the FC of the left superior frontal gyrus (SFG) and the right inferior frontal gyrus (IFG) were activated. The left SFG is known to contribute to higher cognitive functions and working memory. The right IFG is associated with pain processing and empathy for pain. Conclusions: Although only a few patients were enrolled in this study, the PHN could be affected by pain itself, as well as pain memory and psychological aspects such as empathy for pain. Full article
(This article belongs to the Special Issue Chronic Neuropathic Pain Therapy and Anaesthesia)
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