T. Goroszeniuk

• FFARCSI, FFPMCAI
• Interventional Pain Managament and Neuromodulation Practice

Please confirm that an ethics committee approval has been applied for or granted Not relevant Background and Aims Background and aims Transcutaneous electrical nerve stimulation (TENS) is an established technique for pain management. There is evidence that stimulation delivered through a dome-shaped electrode is associated with improved clinical o...

Analgesic effect of 2-Hz electric percutaneous neuromodulation in participants suffering from neuropathic pain

This is part 2 of a 3-part article on the history, current practice and future directions of peripheral neuromodulation. In part 1, we previously covered the theory of peripheral nerve stimulation. In part 2, we present the role of peripheral modulation for specific clinical indications. Stimulation of nerve plexuses Brachial plexus stimulation Neu...

Chronic pain attributed to the abdominal wall is seen in 10-30% of patients who present to specialist pain clinics [24]. The most common cause is abdominal cutaneous nerve entrapment syndrome (ACNES). Trauma, including surgical incisions and tissue scarring, are well accepted causes of cutaneous nerve entrapment causing neuropathic pain [24]. The o...

Chronic pain has become dominant problem in recent years affecting not only patient quality of life but having economic impact and heavy burden on the health systems. The first line in pain management would be patient education, physical rehabilitation and pharmacotherapy. Unfortunately aforementioned treatment often appears incomplete and speciali...

Objective To report a retrospective review of the longer‐term results of peripheral neuromodulation in 12 patients with significant chronic sacroiliac joint pain who had previously failed multiple conservative and interventional pain therapies. Methods To allow for the assessment of meaningful longer‐term outcome, implants for all 12 patients had...

Peripheral nerve stimulation (PNS) is rapidly expanding area of neuromodulation with multiple new indications for chronic pain treatment and function improvement. Since the first percutaneous lead insertion in 1999, the proliferation of nonsurgical techniques with increasingly diverse stimulating targets has resulted that PNS is now a firmly establ...

The above article, first published online on 13 April 2017 in Wiley Online Library ( www.onlinelibrary.wiley.com ) has been retracted by agreement between the authors, the Editor‐in‐Chief, E.A. Joosten, and Wiley Periodicals, Inc. The retraction has been agreed at the request of the authors, who advised that it has been brought to their attention t...

The use of peripheral approaches to chronic abdominal pain follows the rapid increase in its use in other pain states. Although the mechanism of action in peripheral Neuromodulation is not as well established as spinal cord stimulation, it may have differences that will allow it to work either as a standalone therapy or in combination with conventi...

Peripheral nerve stimulation (PNS) is likely the most diverse and rapidly expanding area of neuromodulation. Its expansion has become possible due to both technological and clinical advances in pain medicine. The first implantable systems were surgically placed. However, it is currently commonplace to use percutaneous leads, as this approach has be...

Purpose: To compare the use of ropivacaine versus bupivacaine for 3-in-1 block during total knee arthroplasty (TKA) in terms of efficacy and safety (lack of toxicity). Methods: 14 men and 26 women aged 58 to 77 (median, 70) years who had the American Society of Anesthesiologists (ASA) grades I to III physical status were randomised to receive ro...

Persistent post surgical pain is reported in 70% of patients following thoracotomy and mastectomy. This pain is often neuropathic in nature and occasionally it is refractory to traditional medical and interventional management. Neurostimulation of peripheral nerves can be a highly effective clinical modality for the management of neuropathic pain....

  The management of pain in chronic benign pancreatitis is complex. Celiac plexus neurolysis provides pain relief of variable duration. Neuromodulation of splanchnic nerves with electrodes and an implantable pulse generator system is an alternative to producing long-term pain relief with minimal complications in selected cases.   A 36-year-old lady...

Spinal cord stimulation is now established as an effective treatment for refractory angina. We present the use of an alternative approach to neuromodulation of anginal pain using subcutaneous leads placed at the site of pain. In this case series, five patients with refractory angina received successful treatment with subcutaneous target stimulation...

This chapter focuses on the subcutaneous targeted stimulation (TS), which is a new development for neuromodulatory therapies that is dynamically expanding in acceptance, popularity, and use, due to its minimally invasive, simple approach and its therapeutic and cost effectiveness. Applying the concept of peripheral nerve stimulation (PNS) to pain i...

Introduction Loin pain-hematuria syndrome (LPHS) is a rare clinical entity causing unilateral or bilateral intractable flank and loin pain with hematuria. The etiology is poorly understood, and the diagnosis is made by exclusion of urological and nephrological conditions. The management is mainly symptomatic aiming for pain relief with nonopioid an...

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Subcutaneous targeted neuromodulation is one part of the wider new peripheral neuromodulation development in the treatment of neuropathic pain. Although it has not received wider acceptance, there are many reports in the literature of successful use of this technique.

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The addition of clonidine to local anesthesia prolongs the local anesthetic action, but in humans, the contribution of a peripheral mechanism remains unclear. We investigated clonidine's peripheral effect in 20 healthy volunteers undergoing double-blind, subcutaneous infiltration of 0.5% lidocaine with normal saline to one forearm and then, immedia...

Introduction Intractable pain in the affected arm is a common sequel to severe traction lesions of the brachial plexus. Its management presents a challenge. Existing interventional therapies are not effective for the intractable pain from brachial plexus traction lesions, in the long term. Spinal cord stimulation is indicated for the relief of pain...

Primary afferent stimulation for the control of chronic pain frequently offers the optimal compromise for the control of intractable pain. We describe a new access route directly to the site of pain (target) in the form of subcutaneous targeted neurostimulation (STN) via a percutaneous permanent neurostimulating implant. We present 3 cases with chr...

An abstract is unavailable. This article is available as HTML full text and PDF.

An abstract is unavailable. This article is available as HTML full text and PDF.

An abstract is unavailable. This article is available as HTML full text and PDF.

An abstract is unavailable. This article is available as HTML full text and PDF.

The psoas compartment block is used to produce analgesia of the lumbar plexus mainly for hip and knee surgery. It has also been used for the management of a long-standing pain due to hip joint degeneration. A 55-year-old woman with severe left hip pain received repetitive psoas compartment blocks over 18 months. The blocks provided her with effecti...

Pressure changes around the femoral nerve were monitored throughout 10 consecutive primary total hip replacements to identify any surgical steps that might raise pressure around the nerve and be implicated in iatropathic palsy. The only notable variable was the patient himself/herself. The only step that consistently raised pressure around the nerv...

Hysteria as a cause of failure to recover consciousness following general anaesthesia is a rare event. This case report describes such an instance in a young, healthy 22-year-old female suffering severe dental phobia who was undergoing dental conservation. The literature is reviewed and a summary of the possible physiological mechanisms involved is...

Two low-volume, variable performance oxygen delivery systems were compared in conscious spontaneously breathing volunteers. Oropharyngeal oxygen concentrations were measured during periods of nose and mouth breathing. The systems were studied at oxygen flow rates of 2 or 4 litres/minute. The performance of both systems was similar under the test co...

Two low-volume, variable performance oxygen delivery Systems were compared in conscious spontaneously breathing volunteers. Oropharyngeal oxygen concentrations were measured during periods of nose and mouth breathing. The Systems were studied at oxygen flow rates of 2 or 4 litres/minute. The performance of both Systems was similar under the test co...

Oral temazepam was compared with papaveretum and hyoscine for pre-operative medication. The oral premedication was associated with less subjective unpleasant side-effects and greater anxiolytic properties. It was adjudged to be superior by the anaesthetic and nursing staff as well as by the patients themselves. Oral premedication was also less time...

A mother presented at 28 weeks with epileptiform convulsions which were due to a malignant cerebral tumour. Labour and delivery at 34 weeks were managed under epidural analgesia. The infant was healthy, but the mother died several days later following cerebral decompression.

One hundred and twenty-six mothers undergoing caesarean section with epidural anaesthesia were offered music from a portable cassette player with headphones. One hundred and ten accepted the offer and most felt that the music was very beneficial.

To find out whether morbidity in the first postoperative week is affected by type of anaesthetic technique, healthy patients who had caesarean sections under epidural anaesthesia were compared with those who were given a general anaesthetic. Epidural anaesthesia was associated with less pain (p less than 0.00001) and discomfort in the immediate pos...

This survey compared the safety of 261 healthy mothers of whom 170 received extradural and 91 general anaesthesia for Caesarean section. Anaesthetics were conducted in routine hospital practice by six anaesthetic registrars. Failed intubation occurred in one patient, awareness was reported by 12 patients following general anaesthesia and two patien...

This survey compared the safety of 261 healthy mothers of whom 170 received extradural and 91 general anaesthesia for CaeSarean section. Anaesthetics were conducted in routine hospital practice by six anaesthetic registrars. Failed intubation occurred in one patient, awareness was reported by 12 patients following general anaesthesia and two patien...

The authors believe that epidural fentanyl is suitable for prolonged use in patients with multiple fractures, whose pain is not responsive to simpler measures. It has clear advantages over a local anaesthetic drug, and it is simple to apply. Epdural opiates may be a useful aid in the terminal care of patients with severe pain, for they should permi...

This single-blind trial in 57 patients showed that fentanyl, diazepam, and atropine appeared to be better premedication for fibreoptic and bronchoscopy than papaveretum and hyoscine. A double blind trial was impossible because one combination was given intravenously at the time of the procedure, the other intramuscularly beforehand. Nevertheless, n...

An anaesthetic technique for unpremedicated patients undergoing minor surgery is described. After the administration of atropine and fentanyl, anaesthesia was induced with methohexitone and maintained with nitrous oxide supplemented when necessary by further small doses of methohexitone. This technique provided good operating conditions and was fre...