Peripheral Nerve Stimulator for the Treatment of Supraorbital Neuralgia: A Retrospective Case Series

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 355-359 ◽  
Author(s):  
S Amin ◽  
A Buvanendran ◽  
K-S Park ◽  
JS Kroin ◽  
M Moric
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Case Series ◽  
Opioid Consumption ◽  
Pain Clinic ◽  
Retrospective Case ◽  
Nerve Blocks ◽  
Peripheral Nerve Stimulator ◽  
Supraorbital Nerve ◽  
Supraorbital Neuralgia

Peripheral nerve blocks of the supraorbital, supratrochlear or occipital nerve have been utilized for the relief of headaches, although relief may be short-lasting. The purpose of this study was to evaluate the efficacy of supraorbital nerve stimulation for treatment of intractable supraorbital neuralgia. Patients presenting to the pain clinic with refractory frontal headaches who responded to a diagnostic supraorbital nerve block were selected for this case series. Patients underwent a trial of supraorbital nerve stimulation, and efficacy was assessed after 5-7 days ( n = 16). From the trial, 10 patients consented to undergo permanent implantation of the stimulator. Opioid consumption and headache scores were monitored preoperatively and at timed intervals for 30 weeks. Headache scores decreased, and opioid consumption was reduced in half, and these beneficial accomplishments were maintained up to 30 weeks after implantation. In selected patients, supraorbital nerve stimulation for the treatment of chronic frontal headaches appears to be efficacious.

Peripheral Nerve Stimulation and Clinical Outcomes: A Retrospective Case Series

Pain Practice ◽  
2020 ◽  
Author(s):  
Nafisseh S. Warner ◽  
Kalli K. Schaefer ◽  
Jason S. Eldrige ◽  
Tim J. Lamer ◽  
Matthew J. Pingree ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Clinical Outcomes ◽  
Nerve Stimulation ◽  
Case Series ◽  
Peripheral Nerve Stimulation ◽  
Retrospective Case ◽  
Retrospective Case Series

scholarly journals A REPORT ON USE OF 10% LIDOCAINE NEUROLYSIS FOR CHRONIC REFRACTORY SUPRAORBITAL NEURALGIA

2018 ◽  
pp. 193-196
Author(s):  
Gaurav Chauhan
Keyword(s):  
Radiofrequency Ablation ◽  
Symptom Control ◽  
Positive Outcome ◽  
Pain Clinic ◽  
Nerve Blocks ◽  
Supraorbital Nerve ◽  
Refractory Headache ◽  
Patient Reported ◽  
Lidocaine Injection ◽  
Supraorbital Neuralgia

We present a case report of a 50-year-old female with a past medical history of chronic headaches diagnosed as supraorbital neuralgia. Her headaches had been refractory to conventional analgesic medications and she had received multiple supraorbital nerve blocks which gave her temporary relief of the headaches lasting up to 2 weeks. The patient also received chemical neurolysis of the supraorbital nerve bilaterally with 10% Lidocaine bilaterally, under fluoroscopic guidance in the pain clinic. The patient reported positive outcome following the block with significant pain control for up to 6-7 months postprocedure. The authors conclude that in a patient with a refractory headache due to supraorbital neuralgia, a 10% lidocaine,injection can be an efficacious alternative to radiofrequency ablation as it yields optimum symptom control for up to 6 - 7 months and is a relatively easy procedure to perform. Furthermore, the procedure is not associated with significant side effects and with reversibility of induced sensory functional deficits, offering an advantage over radiofrequency ablation. Key words: Lidocaine, supraorbital neuralgia, neurolysis, nerve blocks, flouroscopy

Prospective case series on the use of peripheral nerve stimulation for focal mononeuropathy treatment

2019 ◽  
Vol 9 (6) ◽  
pp. 551-558 ◽  
Author(s):  
Jessica Oswald ◽  
Varun Shahi ◽  
Krishnan V Chakravarthy
Keyword(s):  
Peripheral Nerve ◽  
Case Series ◽  
Suprascapular Nerve ◽  
Intercostal Nerve ◽  
Nerve Stimulator ◽  
Patient Case ◽  
Peripheral Nerve Stimulator ◽  
Pain Scores ◽  
Early Results ◽  
Prospective Case Series

Aim: This case series looks at outcomes in 39 patients implanted using the Bioness Stimrouter system on various isolated mononeuropathies. Patients & methods: A case series of 39 patients with a total of 42 implants were enrolled starting August 2017 at various pain management centers. Results: Of 39 patients studied, 78% of the participants noticed an improvement in their pain. There was a 71% reduction in pain scores with the average preprocedure score of 8 improving to 2 post-implant. Participants noted on average a 72% improvement in activity with the greatest observed in the brachial plexus (80%) and suprascapular nerve (80%) and smallest in the intercostal nerve (40%). Approximately 89% of those implanted with a peripheral nerve stimulator experienced a greater than 50% reduction in opioid consumption. Conclusion: Peripheral nerve stimulators are a new, minimally invasive neuromodulation modality that shows promising early results in our 39-patient case series.

scholarly journals Percutaneous Peripheral Nerve Stimulation to Control Postoperative Pain, Decrease Opioid Use, and Accelerate Functional Recovery Following Orthopedic Trauma

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 557-564 ◽  
Author(s):  
Brian M Ilfeld ◽  
Scott T Ball ◽  
Steven P Cohen ◽  
Steven R Hanling ◽  
Ian M Fowler ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Case Series ◽  
Opioid Therapy ◽  
Peripheral Nerve Stimulation ◽  
Orthopedic Trauma ◽  
Opioid Use ◽  
Postamputation Pain ◽  
Improved Function

Abstract Orthopedic trauma is a significant military problem, causing several of the most disabling conditions with high rates of separation from duty and erosion of military readiness. The objective of this report is to summarize the findings of case series of a non-opioid therapy—percutaneous peripheral nerve stimulation (PNS) – and describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9). The orthopedic trauma induced during TKR is highly representative of multiple types of orthopedic trauma sustained by Service members and frequently produces intense, prolonged postoperative pain and extended opioid use following surgery. Collectively, the results of these three clinical studies demonstrated that percutaneous PNS can provide substantial pain relief, reduce opioid use, and improve function. These outcomes suggest that there is substantial potential for the use of percutaneous PNS following orthopedic trauma.

scholarly journals Ultrasound-Guided Peripheral Nerve Stimulation for Knee Pain: A Mini-Review of the Neuroanatomy and the Evidence from Clinical Studies

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S56-S63
Author(s):  
Chih-Peng Lin ◽  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Levent Özçakar
Keyword(s):  
Peripheral Nerve ◽  
Knee Pain ◽  
Nerve Stimulation ◽  
Case Reports ◽  
Case Series ◽  
Peripheral Nerve Stimulation ◽  
Present Review ◽  
Chronic Knee Pain ◽  
Catheter Dislodgement ◽  
Continuous Nerve Block

Abstract Objectives Peri- and postoperative pain frequently develops after joint replacement for severe knee osteoarthritis. A continuous nerve block is commonly used for pain relief, but the risks of infection and catheter dislodgement should be considered. The present mini-review aimed to brief the innervation and neural sonoanatomy of the knee joint and summarize the newest evidence of peripheral nerve stimulation (PNS) use in the management of knee pain. Methods We used a systematic approach to search for relevant articles. We used the combination of “peripheral nerve stimulation” and “knee pain” as the key words for the literature search using the electronic database without language or article type restriction. The search period was from the earliest record to August 2019. Results The present review identified six studies, four of which were related to PNS for management of postoperative knee pain and two of which probed neuropathic pain. Most of the studies were either case series or case reports. Based on our search result, PNS is likely to be a feasible and safe treatment for knee pain, but its effectiveness remains uncertain. Conclusions The present review reveals that PNS is feasible for the management of knee pain, especially in the postoperative period. The procedure is safe under ultrasound guidance used for proper placement of the electrodes near the target nerves. In the future, more prospective randomized controlled trials are needed to validate the effectiveness of PNS in acute and chronic knee pain.

Regional anaesthesia of the lower limb

2017 ◽  
Author(s):  
Pawan Gupta ◽  
Anurag Vats
Keyword(s):  
Peripheral Nerve ◽  
Local Anaesthetic ◽  
Lower Limb ◽  
Peripheral Nerves ◽  
Femoral Nerve ◽  
Epidural Haematoma ◽  
Detailed Knowledge ◽  
Success Rates ◽  
Nerve Blocks ◽  
Peripheral Nerve Stimulator

Lower limb nerve blocks gained popularity with the introduction of better nerve localization techniques such as peripheral nerve stimulation and ultrasound. A combination of lower limb peripheral nerve blocks can provide anaesthesia and analgesia of the entire lower limb. Lower limb blocks, as compared to central neuraxial blocks, do not affect blood pressure, can be used in sick patients, provide longer-lasting analgesia, avoid the risk of epidural haematoma or urinary retention, provide better patient satisfaction, and have acceptable success rates in experienced hands. Detailed knowledge of the relevant anatomy is essential before performing any nerve blocks in the lower limb as the nerve plexuses and the peripheral nerves are deep and obscured by bony structures and large muscles. The lumbosacral plexus provides sensory and motor innervation to the superficial tissues, muscles, and bones of the lower limb. This chapter covers different approaches and techniques for lower limb blocks, that is, the lumbar plexus, femoral nerve, fascia iliaca, saphenous nerve, sciatic nerve, popliteal nerve, ankle block, forefoot block, and the intra-articular infusion of local anaesthetics. Both peripheral nerve stimulator- and ultrasound-guided approaches are discussed. The use of ultrasound guidance is suggested as it helps in reducing the dose of local anaesthetic required and can ensure circumferential spread of local anaesthetic around peripheral nerves, which hastens the onset of block and improves success rate.

scholarly journals Fully Implantable Peripheral Nerve Stimulation for Hemiplegic Shoulder Pain: A Multi-Site Case Series With Two-Year Follow-Up

2017 ◽  
Vol 21 (3) ◽  
pp. 290-295 ◽  
Author(s):  
Richard D. Wilson ◽  
Maria E. Bennett ◽  
Vu Q.C. Nguyen ◽  
William C. Bock ◽  
Michael W. O'Dell ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Case Series ◽  
Peripheral Nerve Stimulation

scholarly journals Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Anupama Wadhwa ◽  
Sunitha Kanchi Kandadai ◽  
Sujittra Tongpresert ◽  
Detlef Obal ◽  
Ralf Erich Gebhard
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Nerve Stimulation ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Sense Of Security ◽  
False Sense ◽  
Anesthesia Technique ◽  
Additional Value

Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits.

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