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Title: | Update on Interventional Management of Neuropathic Pain: A Delphi Consensus of the Spanish Pain Society Neuropathic Pain Task Force |
Author: | Serrano Afonso, Ancor Gálvez, Rafael Paramés, Elena Navarro, Ana Ochoa, Dolores Pérez Hernández, Concepción |
Keywords: | Dolor Manifestacions neurològiques de les malalties Neuropaties perifèriques Pain Neurologic manifestations of general diseases Peripheral neuropathies |
Issue Date: | 30-Apr-2022 |
Publisher: | MDPI AG |
Abstract: | Background and Objectives: Interventional management of neuropathic pain (NP) is available to the patients who do not obtain satisfactory pain relief with pharmacotherapy. Evidence supporting this is sparse and fragmented. We attempted to summarize and critically appraise the existing data to identify strategies that yield the greatest benefit, guide clinicians, and identify areas that merit further investigation. Material and Methods: A two-round Delphi survey that involved pain clinic specialists with experience in the research and management of NP was done over an ad hoc 26-item questionnaire made by the authors. Consensus on each statement was defined as either at least 80% endorsement or rejection after the 2nd round. Results: Thirty-five and 29 panelists participated in the 1st and 2nd round, respectively. Consensus was reached in 20 out of 26 statements. There is sufficient basis to treat postherpetic neuralgias and complex regional pain syndromes with progressive levels of invasiveness and failed back surgery syndrome with neuromodulation. Radiculopathies and localized NP can be treated with peripheral blocks, neuromodulation, or pulsed radiofrequency. Non-ablative radiofrequency and non-paresthetic neuromodulation are efficacious and better tolerated than ablative and suprathreshold procedures. Conclusions: A graded approach, from least to most invasive interventions has the potential to improve outcomes in many patients with common refractory NP conditions. Preliminary promising data warrant further research on new indications, and technical advances might enhance the safety and efficacy of current and future therapies. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/medicina58050627 |
It is part of: | Medicina, 2022, vol. 58, num. 5, p. 627 |
URI: | http://hdl.handle.net/2445/186726 |
Related resource: | https://doi.org/10.3390/medicina58050627 |
ISSN: | 1648-9144 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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