Abstract Description
Institution: Central Virginia Veterans Health Service Center - Richmond, USA
Control of Neuropathic Pain Utilizing Temporary Percutaneous Peripheral Nerve Stimulation
Authors Meenashki Bindal MD, Brooke Trainer MD, Denise Lester MD
Affiliation Central Virginia Veterans Health Care System, 1201 Broad Rock Blvd, #117, Department of PM&R, Richmond, VA 23249
Corresponding author: Denise Lester, MD email Denise . Lester @va.gov
Dr. Denise Lester is an attending Anesthesiologist in the interventional pain clinic under the Department of PM&R.
Dr. Meenashki Bindal is an attending Physiatrist in in the interventional pain clinic in the Department of PM&R.
Dr. Brooke Traineris an attending Anesthesiologist and Intensivist in the Department of Surgery at the Central Virginia Health Care Center, Richmond, VA (CVHSC) and the Virginia Commonwealth University (VCU), and the University of Virginia, Charlottesville, VA (UVA).
Dr. Lester, Dr. Trainer, Dr Bindal participate in clinical research of the SPR peripheral nerve implant devices.
Author Details : First Author Meenashki Bindal co-authors Brooke Trainer and Denise Lester
Description.
Topics: Peripheral Nerve Stimulation For Neuropathic Pain
Background:
Chronic neuropathic pain syndromes are very difficult to treat and occur in up to 70% of the patients seen for a refractory pain syndrome. This includes all types of pain including acute, post operative persistent pain, subacute and chronic pain. For example, it’s reported that up to 70% of individuals undergoing surgeries such as thoracotomies and mastectomies will experience neuropathic post operative persistent pain. A variety of neuropathic treatments have become available including medical interventions (i.e. oral, intravenous and topical agents), surgical interventions (i.e. surgical sympathectomies, dorsal rhizotomies, surgically implanted peripheral nerve and/or spinal cord stimulators), and physical therapy modalities (i.e. TENS units, paraffin wax, desensitizing therapies, magnetic therapies). However, in recent years there has been a resurgence in the use of peripheral nerve stimulators by pain physicians. The authors have implantation of hundreds of the temporary, percutaneous peripheral nerve stimulation devices by SPR therapeutics (SPRINT PNS System). The authors would like to report their Real World Experience of the use of these devices in their facilities (CVHCS, VCU and UVA) over the past 7 years.
During that period they have placed hundreds of the devices to treat a variety of syndromes spanning from Acute Post Operative Amputation Pain, Persistent Guillaume Barre Pain, Chronic Low Back Pain, Chronic Peripheral Nerve Pain (i.e. femoral, suprascapular, sciatic, ilioinguinal, thoracic paravertebral, tibial, saphenous, ulnar, median, cervical median branch nerve, cervical paravertebral), Chronic Joint Pain, as well as End Of Life Cancer pain. All of these painful syndromes exhibited components of neuropathic pain .
Peripheral nerve stimulation is available in two types of systems: one that is implanted permanently and one that is temporarily implanted. Temporary implantation would appear more advantageous than permanent implantation in terms of convenience and the risk of infection and other complications. However, does pain relief continue without the device in place? Recently published studies suggest that pain relief will continue after the removal of the device.
The authors propose a poster session that provides attendees with information concerning the existing research and their real world experiences of temporary peripheral nerve stimulation for neuropathic pain. The authors can also provide information on the indications, contraindications, best practice techniques, and long term follow up when managing these devices The authors will discuss the hardware, the choice of nerve placement for various types of pain, the use of ultrasound in device implantation, post implantation management and the complications, risks and their management. Attendees will have a sound basis after this workshop on which to further pursue training so that they can incorporate this treatment option into their practices.
Presenters
Authors
Authors
Denise Lester, MD, FASAM Anesthesiologist, Interventional Pain Management, Addictionologist Director, Peripheral Nerve Stimulation Program Co-Director, Interventional Pain Research Diplomate, American Board Anesthesiology Diplomate, American Board Pain Medicine Diplomate, American Board Preventive Medicine, Addiction Medicine Denise Lester MD - Central Virginia Veterans Health Service Center , Brooke Trainer MD - , Meenashki Bindal MD -
