Single Center Experience of Spinal Cord Stimulation in Chronic

Abdominal Pain

James R. Bruns, MD; Hammam H. Akbik, MD, Harsh Sachdeva, MD

Department of Anesthesiology, Pain Medicine Division, University of Cincinnati College of Medicine, Cincinnati, OH

Introduction

• Recent evidence has demonstrated the utility of spinal cord stimulation (SCS) in chronic abdominal pain. (1) We reviewed the results of SCS in chronic refractory abdominal pain at our single center to determine if they were comparable to published results.

Methods

• All patients treated with SCS for chronic abdominal pain between 2008-2010 at the University of Cincinnati Pain Management Center were evaluated.

• Patient reported pain improvement scores were recorded along with opioid use.

• Opioid use was converted into oral morphine equivalents using GlobalRPH online narcotic calculator. (2)

• Follow up of pts ranged from 4 months to 1 year

Results

• 11 consecutive patients were identified that received SCS for

abdominal pain. – Etiology of pain included:

pancreatitis (n=4), adhesions (n=2) and chronic abdominal pain nos (n =5).

– All patients initially underwent a trial lasting from 5 to 7 days.

– 2 octad leads were placed in the T6-T8 region during both the trial and implant

Results

– Of the 11 patients, 8 had a positive response and were ultimately implanted with a permanent stimulator.

– The 3 patients that did not receive permanent implant reported minimal improvements in their pain (0-10%).

– The 8 that had a positive response reported pain improvement scores that averaged 83% (range 50-100%).

– Opioid use decreased 77% (range 49%-100%), from 112 mg (range 20-288 mg) to 16 mg (range 0-60 mg) opioid equivalents.

Results

Conclusions

• Our results are consistent with prior studies that suggest SCS is a viable option for treatment refractory abdominal pain.

• Most of our patients reported significant decreases in both reported pain scores and opioid use.

• Three of the 8 patients were completely weaned of their opioids, one of which was using 288 mg of oral morphine equivalents daily.

References

1.Kapural L, Nagem H, Tlucek H, Sessler D I. Spinal cord stimulation for chronic visceral abdominal pain. Pain Medicine 2010 11: 347–355.

2.http://www.globalrph.com/narcoticonv.htm

Questions?