topographical anatomical neuropathic-pain guided (tang) mapping a tool derived from a patient perspective to facilitate the transition from spinal cord stimulator trial to potential permanent implantation英文论文.pdfVIP

Open Journal of Anesthesiology, 2012, 2, 93-97 1 / 10.4236/ojanes.2012.23022 Published Online July 2012 (http://www.SciRP.org/journal/ojanes) Topographical Anatomical Neuropathic-Pain Guided (TANG) Mapping: A Tool Derived from a Patient Perspective to Facilitate the Transition from Spinal Cord Stimulator Trial to Potential Permanent Implantation Nelson Tang, Bryt A. Christensen, Kayode A. Williams Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Johns Hopkins Hospital, Baltimore, USA. Email: kwilli64@ Received April 8th th st , 2012; revised May 10 , 2012; accepted June 1 , 2012 ABSTRACT Introduction: Collecting a patient’s pain scores and the analgesic effect achieved during spinal cord stimulation (SCS) trials can be difficult, and no standard exists for doing so. We propose a topographical mapping tool that was derived from a patient’s perspective. Case: A 60-year-old man with postherpetic neuralgia (PHN) underwent a SCS trial after conservative treatment failed to relieve his pain. During the SCS trial, with the SCS off and on in five different settings, he recorded pain levels in each of the six different painful zones he identified. The data collected were transferred to a topographical and anatomical map, which helped the physicians to better understand the effects of the SCS at different settings. Ultimately, the data collected by the patient helped the physicians to implant a permanent SCS successfully. Conclusions: Patient pain diaries have been used in pain medicine for years. This particular patient’s collection of pain scores and SCS effects inspired the construction of a more standardized tool for collecting such data during SCS trials. We propose that use of our Topographical Anatomical Neuropathic-pain Guided (TANG)