Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura

Detalhes bibliográficos
Autor(a) principal: Fernandes, Matheus Pereira
Data de Publicação: 2020
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório do Centro Universitário Braz Cubas
Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1453
Resumo: Introduction: According to the International Association for the Study of Pain, pain is defined as a sensitive and unpleasant experience associated with actual or potential tissue damage. According to the temporal parameters, it can be classified as acute when it exerts a defensive alert tone against an injury, and lasts less than three months; and chronic when it lasts more than three months, not exercising a biological protective role. Conservative treatment can be based on drug therapies with the use of drugs, non-invasive anesthetic techniques, physical therapy and psychotherapy. Spinal cord stimulation is a neuromodulation technique that involves surgical or percutaneous implantation of electrodes in the epidural space, in the region of the dorsal horn of the spinal cord. It consists of replacing the sensation of pain by paresthesia, through the electric current. Objectives: To describe spinal cord stimulation in the management of chronic pain; explain the functional mechanism of spinal cord stimulation, describing the technical parameters of stimulation, report how the implantation stages of the electrodes, elucidate the main indications, list the main reconstructed complications. Materials and Methods: Exploratory, descriptive, literature review type study. Data collection was carried out from August 2019 to October 2020. Results: In view of the legacy of satisfactory results, EME is a widespread technique for the treatment of painful pathologies refractory to therapies against, including the unsuccessful spinal surgery, complex regional painful syndrome, peripheral vascular disease and intractable angina. Pain scales are used to measure pain magnitude and proportion to the definition of effective therapeutic parameters. As complications are infrequent, however, occurrences of a technical or biological nature may occur. Conclusion: Neuromodulation techniques, therefore, assist in developing to adapt to the reality of patients, with modern software and judicious materials. Therefore, spinal cord stimulation is effective and safe for the treatment of chronic refractory to conventional therapy.
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spelling Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literaturaDor crônicaNeuromodulaçãoMedula espinhalCNPQ::CIENCIAS DA SAUDE::MEDICINAIntroduction: According to the International Association for the Study of Pain, pain is defined as a sensitive and unpleasant experience associated with actual or potential tissue damage. According to the temporal parameters, it can be classified as acute when it exerts a defensive alert tone against an injury, and lasts less than three months; and chronic when it lasts more than three months, not exercising a biological protective role. Conservative treatment can be based on drug therapies with the use of drugs, non-invasive anesthetic techniques, physical therapy and psychotherapy. Spinal cord stimulation is a neuromodulation technique that involves surgical or percutaneous implantation of electrodes in the epidural space, in the region of the dorsal horn of the spinal cord. It consists of replacing the sensation of pain by paresthesia, through the electric current. Objectives: To describe spinal cord stimulation in the management of chronic pain; explain the functional mechanism of spinal cord stimulation, describing the technical parameters of stimulation, report how the implantation stages of the electrodes, elucidate the main indications, list the main reconstructed complications. Materials and Methods: Exploratory, descriptive, literature review type study. Data collection was carried out from August 2019 to October 2020. Results: In view of the legacy of satisfactory results, EME is a widespread technique for the treatment of painful pathologies refractory to therapies against, including the unsuccessful spinal surgery, complex regional painful syndrome, peripheral vascular disease and intractable angina. Pain scales are used to measure pain magnitude and proportion to the definition of effective therapeutic parameters. As complications are infrequent, however, occurrences of a technical or biological nature may occur. Conclusion: Neuromodulation techniques, therefore, assist in developing to adapt to the reality of patients, with modern software and judicious materials. Therefore, spinal cord stimulation is effective and safe for the treatment of chronic refractory to conventional therapy.Introdução: Segundo a Associação Internacional para o Estudo da Dor, a dor é definida como uma experiência sensitiva e emocional desagradável associada a um dano tecidual real ou potencial. De acordo com os parâmetros temporais, pode-se classificá-la como aguda quando exerce uma finalidade de alerta defensivo ante uma lesão, e dura menos de três meses; e crônica quando dura mais de três meses, não exercendo papel biológico de proteção. O tratamento conservador pode ser baseado em terapias medicamentosas com o uso de fármacos, técnicas anestésicas nãoinvasivas, fisioterapia e psicoterapia. A estimulação medular epidural é uma técnica de neuromodulação que envolve a implantação cirúrgica ou percutânea de eletrodos no espaço epidural, na região do corno dorsal da medula. Ela consiste em substituir a sensação de dor por parestesia, através da corrente elétrica. Objetivos: Descrever a estimulação medular epidural no manejo da dor crônica; explanar o mecanismo funcional da estimulação medular epidural, descrever os parâmetros técnicos de estimulação, relatar as etapas de implantação dos eletrodos, elucidar as principais indicações cirúrgicas, elencar as principais complicações cirúrgicas. Materiais e Métodos: Estudo exploratório, descritivo, do tipo revisão de literatura, cuja coleta de dados foi efetuada no período de agosto de 2019 a outubro de 2020. Resultados: Em face ao legado de resultados satisfatórios, a EME é uma técnica amplamente difundida para o tratamento de patologias dolorosas refratárias a terapias convencionais, dentre elas a síndrome do insucesso da cirurgia espinhal, síndrome dolorosa regional complexa, doença vascular periférica e angina intratável. As escalas de dor são utilizadas para mensurar a magnitude álgica e propor a definição de parâmetros terapêuticos eficazes. As complicações são infrequentes, entretanto, podem ocorrer falhas de natureza técnica ou biológica. Conclusão: As técnicas de neuromodulação, portanto, vêm se desenvolvendo para se adaptar à realidade dos pacientes, com softwares modernos e materiais criteriosos. Logo, a estimulação medular epidural é eficaz e segura para o tratamento dor crônica refratária a terapia convencional.Centro Universitário de João PessoaBrasilUNIPÊAndrade, Emerson Magno Fernandes dehttp://lattes.cnpq.br/8755121434441999Fernandes, Matheus Pereira2021-02-03T17:54:26Z2021-02-032021-02-03T17:54:26Z2020-12-10info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisapplication/pdfhttps://repositorio.cruzeirodosul.edu.br/handle/123456789/1453porASHMAWI, H. A.; FREIRE, G. M. G. Peripheral and central sensitization. Revista Dor, [S. l.], v. 17, n. Suppl 1, p. 31–34, 2016. Disponível em: https://doi.org/10.5935/1806-0013.20160044 BASBAUM, A. I.; JESSEL, T. M. Dor. In: KANDEL, E. R. et al. (org.). Princípios de Neurociências. 5. ed. Porto Alegre: AMGH, 2014. p. 462–482. E-book. BENDERSKY, D.; YAMPOLSKY, C. Is Spinal Cord Stimulation Safe? A Review of Its Complications. World Neurosurgery, [S. l.], v. 82, n. 6, p. 1359–1368, 2014. Disponível em: https://doi.org/10.1016/j.wneu.2013.06.012 BREIVIK, H. et al. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, [S. l.], v. 10, n. 4, p. 287–287, 2006. Disponível em: https://doi.org/10.1016/j.ejpain.2005.06.009 BURCKHARDT, C. S.; ANDERSON, K. L. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health and quality of life outcomes, [S. l.], v. 1, p. 60, 2003. Disponível em: https://doi.org/10.1186/1477-7525-1-60 CAMERON, T. Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. Journal of Neurosurgery: Spine, [S. l.], v. 100, n. 3, p. 254–267, 2004. Disponível em: https://doi.org/10.3171/spi.2004.100.3.0254 CAMPOS, W. K. et al. Determinants for Meaningful Clinical Improvement of Pain and Health‐Related Quality of Life After Spinal Cord Stimulation for Chronic Intractable Pain. Neuromodulation: Technology at the Neural Interface, [S. l.], v. 22, n. 3, p. 280–289, 2019. Disponível em: https://doi.org/10.1111/ner.12891 CHAKRAVARTHY, K. et al. Spinal Cord Stimulation for Treating Chronic Pain: Reviewing Preclinical and Clinical Data on Paresthesia-Free High-Frequency Therapy. Neuromodulation, [S. l.], v. 21, n. 1, p. 10–18, 2018. Disponível em: https://doi.org/10.1111/ner.12721 CONGER, A. et al. The Effectiveness of Spinal Cord Stimulation for the Treatment of Axial Low Back Pain: A Systematic Review with Narrative Synthesis. Pain Medicine, [S. l.], v. 0, n. 0, p. 1–14, 2020. Disponível em: https://doi.org/10.1093/pm/pnaa142 CUI, J. et al. Spinal cord stimulation attenuates augmented dorsal horn release of excitatory amino acids in mononeuropathy via a GABAergic mechanism. PAIN, [S. l.], v. 73, n. 1, p. 87–95, 1997. Disponível em: https://doi.org/10.1016/S0304- 3959(97)00077-8 DE RIDDER, D.; VANNESTE, S. Burst and Tonic Spinal Cord Stimulation: Different and Common Brain Mechanisms. Neuromodulation: Technology at the Neural Interface, [S. l.], v. 19, n. 1, p. 47–59, 2016. Disponível em: https://doi.org/10.1111/ner.12368 DEER, T. R. et al. The Appropriate Use of Neurostimulation: Avoidance and Treatment of Complications of Neurostimulation Therapies for the Treatment of Chronic Pain. Neuromodulation: Technology at the Neural Interface, [S. l.], v. 17, n. 6, p. 571–598, 2014. Disponível em: https://doi.org/10.1111/ner.12206 DUPRÉ, D. A. et al. Spinal Cord Stimulator Explantation: Motives for Removal of Surgically Placed Paddle Systems. Pain practice : the official journal of World Institute of Pain, [S. l.], v. 18, n. 4, p. 500–504, 2018. Disponível em: https://doi.org/10.1111/papr.12639 ELDABE, S.; BUCHSER, E.; DUARTE, R. V. Complications of Spinal Cord Stimulation and Peripheral Nerve Stimulation Techniques: A Review of the Literature. 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Disponível em: https://doi.org/10.1001/jama.280.2.147 HAUTVAST, R. W. M. et al. Spinal cord stimulation in chronic intractable angina pectoris: A randomized, controlled efficacy study. American Heart Journal, [S. l.], v. 136, n. 6, p. 1114–1120, 1998. Disponível em: https://doi.org/10.1016/S0002- 8703(98)70171-1 HEAD, J. et al. Waves of Pain Relief: A Systematic Review of Clinical Trials in Spinal Cord Stimulation Waveforms for the Treatment of Chronic Neuropathic Low Back and Leg Pain. World neurosurgery, [S. l.], v. 131, p. 264- 274.e3, 2019. Disponível em: https://doi.org/10.1016/j.wneu.2019.07.167 JAMES, S. L. et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, [S. l.], v. 392, n. 10159, p. 1789–1858, 2018. Disponível em: https://doi.org/10.1016/S0140-6736(18)32279-7 JIVEGÅRD, L. E. 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dc.title.none.fl_str_mv Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
title Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
spellingShingle Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
Fernandes, Matheus Pereira
Dor crônica
Neuromodulação
Medula espinhal
CNPQ::CIENCIAS DA SAUDE::MEDICINA
title_short Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
title_full Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
title_fullStr Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
title_full_unstemmed Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
title_sort Estimulação medular epidural para o tratamento da dor crônica: uma revisão de literatura
author Fernandes, Matheus Pereira
author_facet Fernandes, Matheus Pereira
author_role author
dc.contributor.none.fl_str_mv Andrade, Emerson Magno Fernandes de
http://lattes.cnpq.br/8755121434441999
dc.contributor.author.fl_str_mv Fernandes, Matheus Pereira
dc.subject.por.fl_str_mv Dor crônica
Neuromodulação
Medula espinhal
CNPQ::CIENCIAS DA SAUDE::MEDICINA
topic Dor crônica
Neuromodulação
Medula espinhal
CNPQ::CIENCIAS DA SAUDE::MEDICINA
description Introduction: According to the International Association for the Study of Pain, pain is defined as a sensitive and unpleasant experience associated with actual or potential tissue damage. According to the temporal parameters, it can be classified as acute when it exerts a defensive alert tone against an injury, and lasts less than three months; and chronic when it lasts more than three months, not exercising a biological protective role. Conservative treatment can be based on drug therapies with the use of drugs, non-invasive anesthetic techniques, physical therapy and psychotherapy. Spinal cord stimulation is a neuromodulation technique that involves surgical or percutaneous implantation of electrodes in the epidural space, in the region of the dorsal horn of the spinal cord. It consists of replacing the sensation of pain by paresthesia, through the electric current. Objectives: To describe spinal cord stimulation in the management of chronic pain; explain the functional mechanism of spinal cord stimulation, describing the technical parameters of stimulation, report how the implantation stages of the electrodes, elucidate the main indications, list the main reconstructed complications. Materials and Methods: Exploratory, descriptive, literature review type study. Data collection was carried out from August 2019 to October 2020. Results: In view of the legacy of satisfactory results, EME is a widespread technique for the treatment of painful pathologies refractory to therapies against, including the unsuccessful spinal surgery, complex regional painful syndrome, peripheral vascular disease and intractable angina. Pain scales are used to measure pain magnitude and proportion to the definition of effective therapeutic parameters. As complications are infrequent, however, occurrences of a technical or biological nature may occur. Conclusion: Neuromodulation techniques, therefore, assist in developing to adapt to the reality of patients, with modern software and judicious materials. Therefore, spinal cord stimulation is effective and safe for the treatment of chronic refractory to conventional therapy.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-10
2021-02-03T17:54:26Z
2021-02-03
2021-02-03T17:54:26Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.cruzeirodosul.edu.br/handle/123456789/1453
url https://repositorio.cruzeirodosul.edu.br/handle/123456789/1453
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv ASHMAWI, H. A.; FREIRE, G. M. G. Peripheral and central sensitization. Revista Dor, [S. l.], v. 17, n. Suppl 1, p. 31–34, 2016. Disponível em: https://doi.org/10.5935/1806-0013.20160044 BASBAUM, A. I.; JESSEL, T. M. Dor. In: KANDEL, E. R. et al. (org.). Princípios de Neurociências. 5. ed. Porto Alegre: AMGH, 2014. p. 462–482. E-book. BENDERSKY, D.; YAMPOLSKY, C. Is Spinal Cord Stimulation Safe? A Review of Its Complications. World Neurosurgery, [S. l.], v. 82, n. 6, p. 1359–1368, 2014. Disponível em: https://doi.org/10.1016/j.wneu.2013.06.012 BREIVIK, H. et al. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, [S. l.], v. 10, n. 4, p. 287–287, 2006. Disponível em: https://doi.org/10.1016/j.ejpain.2005.06.009 BURCKHARDT, C. S.; ANDERSON, K. L. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health and quality of life outcomes, [S. l.], v. 1, p. 60, 2003. 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publisher.none.fl_str_mv Centro Universitário de João Pessoa
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