Interventional Treatments for Visceral Pain, Including Neuromodulation: A Practical View

Outline

• Why some nerve blocks are useful for treating visceral pain, and others are not
• Spinal cord stimulation for refractory angina pectoris
• Treatment of chronic abdominal pain with 10-kHz spinal cord stimulation
• Direct peripheral nerve stimulation
• Tibial nerve stimulation
• Sphenopalatine ganglion radiofrequency ablation
• Sacral dorsal root ganglion stimulation for refractory anorectal pain

Accreditation & Designation

Release date: This activity was released 8/20/2022.

Termination date: The content of this activity remains eligible for CME Credit until 8/19/2025, unless reviewed or amended prior to this date.

Claiming Credit: Watch the entire presentation and complete the Improvement Plan/Evaluation.

Neurovations Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Neurovations Education designates this other activity (blended learning) for a maximum of 0.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity includes discussions of unlabeled or investigational uses of commercial and/or developmental products.

This activity includes discussions and explorations of new and evolving topics. Such inclusion includes adequate justifications of statements based upon current science, evidence and clinical reasoning.

Disclosure of Financial Relationships

Neither the presenter, reviewers nor any other person with control of, or responsibility for, the planning, delivery, or evaluation of accredited continuing education has, or has had within the past 24 months, any financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Additional Reading

• Cheng, J., & Rosenquist, R. W. (Eds.). (2018). Fundamentals of Pain Medicine. Springer International Publishing.
• Cheng, J. (2021). Is It Time to Redefine Neuropathic Pain?. Pain Medicine, 22(12), 2801-2802.
• Mekhail, N. A., Cheng, J., Narouze, S., Kapural, L., Mekhail, M. N., & Deer, T. (2010). Clinical applications of neurostimulation: forty years later. Pain Practice, 10(2), 103-112.
• Mekhail, N. A., Mathews, M., Nageeb, F., Guirguis, M., Mekhail, M. N., & Cheng, J. (2011). Retrospective review of 707 cases of spinal cord stimulation: indications and complications. Pain practice, 11(2), 148-153.
• Xu, J., Liu, A., & Cheng, J. (2017). New advancements in spinal cord stimulation for chronic pain management. Current Opinion in Anaesthesiology, 30(6), 710-717.
• Xu, L., Sun, Z., Casserly, E., Nasr, C., Cheng, J., & Xu, J. (2022). Advances in interventional therapies for painful diabetic neuropathy: a systematic review. Anesthesia & Analgesia, 134(6), 1215-1228.
• Kapural, L., Gupta, M., Paicius, R., Strodtbeck, W., Vorenkamp, K. E., Gilmore, C., ... & Province-Azalde, R. (2020). Treatment of chronic abdominal pain with 10-kHz spinal cord stimulation: safety and efficacy results from a 12-month prospective, multicenter, feasibility study. Clinical and translational gastroenterology, 11(2).
• Hale, J., Bailey-Classen, A., & Cheng, J. (2020). Spinal cord stimulation for refractory angina pectoris. Pain Medicine, 21(1), 198-200.
• Xu, J., Sun, Z., Wu, J., Rana, M., Garza, J., Zhu, A. C., ... & Cheng, J. (2021). Peripheral nerve stimulation in pain management: a systematic review. Pain Physician, 24(2), E131.
• Chmiela, M. A., Hendrickson, M., Hale, J., Liang, C., Telefus, P., Sagir, A., & Stanton-Hicks, M. (2021). Direct peripheral nerve stimulation for the treatment of complex regional pain syndrome: a 30-year review. Neuromodulation: Technology at the Neural Interface, 24(6), 971-982.
• Narouze, S., Kapural, L., Casanova, J., & Mekhail, N. (2009). Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache. Headache: The Journal of Head and Face Pain, 49(4), 571-577.
• Schoenen, J., Jensen, R. H., Lanteri-Minet, M., Láinez, M. J., Gaul, C., Goodman, A. M., ... & May, A. (2013). Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: a randomized, sham-controlled study. Cephalalgia, 33(10), 816-830.
• Jürgens, T. P., Barloese, M., May, A., Láinez, J. M., Schoenen, J., Gaul, C., ... & Jensen, R. H. (2017). Long-term effectiveness of sphenopalatine ganglion stimulation for cluster headache. Cephalalgia, 37(5), 423-434.
• Kabay, S., Kabay, S. C., Yucel, M., & Ozden, H. (2009). Efficiency of posterior tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain: a Sham-Controlled Comparative Study. Urologia internationalis, 83(1), 33-38.
• Deygoo J, Chauhan G, Cheng J. Sacral dorsal root ganglion stimulation for refractory anorectal pain: A case report. 10th World Congress of the World Institute of Pain (WIP 2020), August 26-29, 2020, Rome, Italy.