Analgesic efficacy of theta-burst stimulation for postoperative pain
•We evaluated the efficacy of intermittent theta-burst stimulation (iTBS) in postoperative care across two cortical targets.•iTBS reduced anaesthetic pump attempts.•This effect was unique to DLPFC stimulation while M1 had no effect. Repetitive transcranial magnetic stimulation (rTMS) may be a releva...
Gespeichert in:
| Veröffentlicht in: | Clinical neurophysiology 2023-05, Vol.149, p.81-87 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 87 |
|---|---|
| container_issue | |
| container_start_page | 81 |
| container_title | Clinical neurophysiology |
| container_volume | 149 |
| creator | Cheng, Ming Che, Xianwei Ye, Yang He, Changlin Yu, Liang Lv, Yating Fitzgerald, Paul B. Cash, Robin F.H. Fitzgibbon, Bernadette M. |
| description | •We evaluated the efficacy of intermittent theta-burst stimulation (iTBS) in postoperative care across two cortical targets.•iTBS reduced anaesthetic pump attempts.•This effect was unique to DLPFC stimulation while M1 had no effect.
Repetitive transcranial magnetic stimulation (rTMS) may be a relevant method to assist postoperative pain. However, studies to date have only used conventional 10 Hz rTMS and targeted the DLPFC for postoperative pain. A more recent form of rTMS, termed intermittent Theta Burst Stimulation (iTBS), enables to increase cortical excitability in a short period of time. This preliminary double-blind, randomised, sham controlled study was designed to evaluate the efficacy of iTBS in postoperative care across two distinct stimulation targets.
A group of 45 patients post laparoscopic surgery were randomised to receive a single session of iTBS over either the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), or Sham stimulation (1:1:1 ratio). Outcome measurements were number of pump attempts, total anaesthetic volume used, and self-rated pain experience, assessed at 1 hour, 6 hours, 24 hours, and 48 hours post stimulation. All randomised patients were analysed (n = 15 in each group).
Compared to Sham stimulation, DLPFC-iTBS reduced pump attempts at 6 (DLPFC = 0.73 ± 0.88, Sham = 2.36 ± 1.65, P = 0.031), 24 (DLPFC = 1.40 ± 1.24, Sham = 5.03 ± 3.87, P = 0.008), and 48 (DLPFC = 1.47 ± 1.41, Sham = 5.87 ± 4.34, P = 0.014) hours post-surgery, whereby M1 stimulation had no effect. No group effect was observed on total anaesthetics, which was mainly provided through the continuous administration of opioids at a set speed for each group. There was also no group or interaction effect on pain ratings. Pump attempts were positively associated with pain ratings in the DLPFC (r = 0.59, P = 0.02) and M1 (r = 0.56, P = 0.03) stimulation.
Our findings show that iTBS to the DLPFC reduces pump attempts for additional anaesthetics following a laparoscopic surgery. However, reduced pump attempts by DLPFC stimulation did not translate into a significantly smaller volume of total anaesthetic, due to the continuous administration of opioids at a set speed for each group.
Our findings therefore provide preliminary evidence for iTBS targeting the DLPFC to be used to improve postoperative pain management. |
| doi_str_mv | 10.1016/j.clinph.2023.02.174 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2801977170</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1388245723002213</els_id><sourcerecordid>2801977170</sourcerecordid><originalsourceid>FETCH-LOGICAL-c362t-b74befd452070c3389921e85b37fa544d3b81502e3c044196754fd3e6b6c46413</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0EolD4A4SyZJPgV-Jkg1SVp1SJDawtxxlTV2kcbKdS_55UKSxZzWh079yZg9ANwRnBpLjfZLq1Xb_OKKYswzQjgp-gC1IKmpZVTk_HnpVlSnkuZugyhA3GWGBOz9GMFRVjjPIL9LjoVPsFweoEjLFa6X3iTBLXEFVaDz7EJES7HVoVresS43zSuxBdD36c7CDple2u0JlRbYDrY52jz-enj-Vrunp_eVsuVqlmBY1pLXgNpuE5He_QjJVVRQmUec2EUTnnDatLkmMKTGPOSVWInJuGQVEXmhecsDm6m_b23n0PEKLc2qChbVUHbgiSlphUQhCBRymfpNq7EDwY2Xu7VX4vCZYHfnIjJ37ywE9iKkd-o-32mDDUW2j-TL_ARsHDJIDxz50FL4O20GlorAcdZePs_wk_7t2CbQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2801977170</pqid></control><display><type>article</type><title>Analgesic efficacy of theta-burst stimulation for postoperative pain</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Cheng, Ming ; Che, Xianwei ; Ye, Yang ; He, Changlin ; Yu, Liang ; Lv, Yating ; Fitzgerald, Paul B. ; Cash, Robin F.H. ; Fitzgibbon, Bernadette M.</creator><creatorcontrib>Cheng, Ming ; Che, Xianwei ; Ye, Yang ; He, Changlin ; Yu, Liang ; Lv, Yating ; Fitzgerald, Paul B. ; Cash, Robin F.H. ; Fitzgibbon, Bernadette M.</creatorcontrib><description>•We evaluated the efficacy of intermittent theta-burst stimulation (iTBS) in postoperative care across two cortical targets.•iTBS reduced anaesthetic pump attempts.•This effect was unique to DLPFC stimulation while M1 had no effect.
Repetitive transcranial magnetic stimulation (rTMS) may be a relevant method to assist postoperative pain. However, studies to date have only used conventional 10 Hz rTMS and targeted the DLPFC for postoperative pain. A more recent form of rTMS, termed intermittent Theta Burst Stimulation (iTBS), enables to increase cortical excitability in a short period of time. This preliminary double-blind, randomised, sham controlled study was designed to evaluate the efficacy of iTBS in postoperative care across two distinct stimulation targets.
A group of 45 patients post laparoscopic surgery were randomised to receive a single session of iTBS over either the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), or Sham stimulation (1:1:1 ratio). Outcome measurements were number of pump attempts, total anaesthetic volume used, and self-rated pain experience, assessed at 1 hour, 6 hours, 24 hours, and 48 hours post stimulation. All randomised patients were analysed (n = 15 in each group).
Compared to Sham stimulation, DLPFC-iTBS reduced pump attempts at 6 (DLPFC = 0.73 ± 0.88, Sham = 2.36 ± 1.65, P = 0.031), 24 (DLPFC = 1.40 ± 1.24, Sham = 5.03 ± 3.87, P = 0.008), and 48 (DLPFC = 1.47 ± 1.41, Sham = 5.87 ± 4.34, P = 0.014) hours post-surgery, whereby M1 stimulation had no effect. No group effect was observed on total anaesthetics, which was mainly provided through the continuous administration of opioids at a set speed for each group. There was also no group or interaction effect on pain ratings. Pump attempts were positively associated with pain ratings in the DLPFC (r = 0.59, P = 0.02) and M1 (r = 0.56, P = 0.03) stimulation.
Our findings show that iTBS to the DLPFC reduces pump attempts for additional anaesthetics following a laparoscopic surgery. However, reduced pump attempts by DLPFC stimulation did not translate into a significantly smaller volume of total anaesthetic, due to the continuous administration of opioids at a set speed for each group.
Our findings therefore provide preliminary evidence for iTBS targeting the DLPFC to be used to improve postoperative pain management.</description><identifier>ISSN: 1388-2457</identifier><identifier>EISSN: 1872-8952</identifier><identifier>DOI: 10.1016/j.clinph.2023.02.174</identifier><identifier>PMID: 36933324</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Analgesics ; DLPFC ; Double-Blind Method ; Humans ; Motor cortex ; Pain, Postoperative - diagnosis ; Pain, Postoperative - drug therapy ; Postoperative pain ; Prefrontal Cortex - physiology ; TBS ; Transcranial Magnetic Stimulation - methods</subject><ispartof>Clinical neurophysiology, 2023-05, Vol.149, p.81-87</ispartof><rights>2023 International Federation of Clinical Neurophysiology</rights><rights>Copyright © 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-b74befd452070c3389921e85b37fa544d3b81502e3c044196754fd3e6b6c46413</citedby><cites>FETCH-LOGICAL-c362t-b74befd452070c3389921e85b37fa544d3b81502e3c044196754fd3e6b6c46413</cites><orcidid>0000-0002-0039-7306 ; 0000-0002-5547-3361</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clinph.2023.02.174$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36933324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Ming</creatorcontrib><creatorcontrib>Che, Xianwei</creatorcontrib><creatorcontrib>Ye, Yang</creatorcontrib><creatorcontrib>He, Changlin</creatorcontrib><creatorcontrib>Yu, Liang</creatorcontrib><creatorcontrib>Lv, Yating</creatorcontrib><creatorcontrib>Fitzgerald, Paul B.</creatorcontrib><creatorcontrib>Cash, Robin F.H.</creatorcontrib><creatorcontrib>Fitzgibbon, Bernadette M.</creatorcontrib><title>Analgesic efficacy of theta-burst stimulation for postoperative pain</title><title>Clinical neurophysiology</title><addtitle>Clin Neurophysiol</addtitle><description>•We evaluated the efficacy of intermittent theta-burst stimulation (iTBS) in postoperative care across two cortical targets.•iTBS reduced anaesthetic pump attempts.•This effect was unique to DLPFC stimulation while M1 had no effect.
Repetitive transcranial magnetic stimulation (rTMS) may be a relevant method to assist postoperative pain. However, studies to date have only used conventional 10 Hz rTMS and targeted the DLPFC for postoperative pain. A more recent form of rTMS, termed intermittent Theta Burst Stimulation (iTBS), enables to increase cortical excitability in a short period of time. This preliminary double-blind, randomised, sham controlled study was designed to evaluate the efficacy of iTBS in postoperative care across two distinct stimulation targets.
A group of 45 patients post laparoscopic surgery were randomised to receive a single session of iTBS over either the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), or Sham stimulation (1:1:1 ratio). Outcome measurements were number of pump attempts, total anaesthetic volume used, and self-rated pain experience, assessed at 1 hour, 6 hours, 24 hours, and 48 hours post stimulation. All randomised patients were analysed (n = 15 in each group).
Compared to Sham stimulation, DLPFC-iTBS reduced pump attempts at 6 (DLPFC = 0.73 ± 0.88, Sham = 2.36 ± 1.65, P = 0.031), 24 (DLPFC = 1.40 ± 1.24, Sham = 5.03 ± 3.87, P = 0.008), and 48 (DLPFC = 1.47 ± 1.41, Sham = 5.87 ± 4.34, P = 0.014) hours post-surgery, whereby M1 stimulation had no effect. No group effect was observed on total anaesthetics, which was mainly provided through the continuous administration of opioids at a set speed for each group. There was also no group or interaction effect on pain ratings. Pump attempts were positively associated with pain ratings in the DLPFC (r = 0.59, P = 0.02) and M1 (r = 0.56, P = 0.03) stimulation.
Our findings show that iTBS to the DLPFC reduces pump attempts for additional anaesthetics following a laparoscopic surgery. However, reduced pump attempts by DLPFC stimulation did not translate into a significantly smaller volume of total anaesthetic, due to the continuous administration of opioids at a set speed for each group.
Our findings therefore provide preliminary evidence for iTBS targeting the DLPFC to be used to improve postoperative pain management.</description><subject>Analgesics</subject><subject>DLPFC</subject><subject>Double-Blind Method</subject><subject>Humans</subject><subject>Motor cortex</subject><subject>Pain, Postoperative - diagnosis</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Postoperative pain</subject><subject>Prefrontal Cortex - physiology</subject><subject>TBS</subject><subject>Transcranial Magnetic Stimulation - methods</subject><issn>1388-2457</issn><issn>1872-8952</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EolD4A4SyZJPgV-Jkg1SVp1SJDawtxxlTV2kcbKdS_55UKSxZzWh079yZg9ANwRnBpLjfZLq1Xb_OKKYswzQjgp-gC1IKmpZVTk_HnpVlSnkuZugyhA3GWGBOz9GMFRVjjPIL9LjoVPsFweoEjLFa6X3iTBLXEFVaDz7EJES7HVoVresS43zSuxBdD36c7CDple2u0JlRbYDrY52jz-enj-Vrunp_eVsuVqlmBY1pLXgNpuE5He_QjJVVRQmUec2EUTnnDatLkmMKTGPOSVWInJuGQVEXmhecsDm6m_b23n0PEKLc2qChbVUHbgiSlphUQhCBRymfpNq7EDwY2Xu7VX4vCZYHfnIjJ37ywE9iKkd-o-32mDDUW2j-TL_ARsHDJIDxz50FL4O20GlorAcdZePs_wk_7t2CbQ</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Cheng, Ming</creator><creator>Che, Xianwei</creator><creator>Ye, Yang</creator><creator>He, Changlin</creator><creator>Yu, Liang</creator><creator>Lv, Yating</creator><creator>Fitzgerald, Paul B.</creator><creator>Cash, Robin F.H.</creator><creator>Fitzgibbon, Bernadette M.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0039-7306</orcidid><orcidid>https://orcid.org/0000-0002-5547-3361</orcidid></search><sort><creationdate>202305</creationdate><title>Analgesic efficacy of theta-burst stimulation for postoperative pain</title><author>Cheng, Ming ; Che, Xianwei ; Ye, Yang ; He, Changlin ; Yu, Liang ; Lv, Yating ; Fitzgerald, Paul B. ; Cash, Robin F.H. ; Fitzgibbon, Bernadette M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-b74befd452070c3389921e85b37fa544d3b81502e3c044196754fd3e6b6c46413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analgesics</topic><topic>DLPFC</topic><topic>Double-Blind Method</topic><topic>Humans</topic><topic>Motor cortex</topic><topic>Pain, Postoperative - diagnosis</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Postoperative pain</topic><topic>Prefrontal Cortex - physiology</topic><topic>TBS</topic><topic>Transcranial Magnetic Stimulation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Ming</creatorcontrib><creatorcontrib>Che, Xianwei</creatorcontrib><creatorcontrib>Ye, Yang</creatorcontrib><creatorcontrib>He, Changlin</creatorcontrib><creatorcontrib>Yu, Liang</creatorcontrib><creatorcontrib>Lv, Yating</creatorcontrib><creatorcontrib>Fitzgerald, Paul B.</creatorcontrib><creatorcontrib>Cash, Robin F.H.</creatorcontrib><creatorcontrib>Fitzgibbon, Bernadette M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neurophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Ming</au><au>Che, Xianwei</au><au>Ye, Yang</au><au>He, Changlin</au><au>Yu, Liang</au><au>Lv, Yating</au><au>Fitzgerald, Paul B.</au><au>Cash, Robin F.H.</au><au>Fitzgibbon, Bernadette M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analgesic efficacy of theta-burst stimulation for postoperative pain</atitle><jtitle>Clinical neurophysiology</jtitle><addtitle>Clin Neurophysiol</addtitle><date>2023-05</date><risdate>2023</risdate><volume>149</volume><spage>81</spage><epage>87</epage><pages>81-87</pages><issn>1388-2457</issn><eissn>1872-8952</eissn><abstract>•We evaluated the efficacy of intermittent theta-burst stimulation (iTBS) in postoperative care across two cortical targets.•iTBS reduced anaesthetic pump attempts.•This effect was unique to DLPFC stimulation while M1 had no effect.
Repetitive transcranial magnetic stimulation (rTMS) may be a relevant method to assist postoperative pain. However, studies to date have only used conventional 10 Hz rTMS and targeted the DLPFC for postoperative pain. A more recent form of rTMS, termed intermittent Theta Burst Stimulation (iTBS), enables to increase cortical excitability in a short period of time. This preliminary double-blind, randomised, sham controlled study was designed to evaluate the efficacy of iTBS in postoperative care across two distinct stimulation targets.
A group of 45 patients post laparoscopic surgery were randomised to receive a single session of iTBS over either the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), or Sham stimulation (1:1:1 ratio). Outcome measurements were number of pump attempts, total anaesthetic volume used, and self-rated pain experience, assessed at 1 hour, 6 hours, 24 hours, and 48 hours post stimulation. All randomised patients were analysed (n = 15 in each group).
Compared to Sham stimulation, DLPFC-iTBS reduced pump attempts at 6 (DLPFC = 0.73 ± 0.88, Sham = 2.36 ± 1.65, P = 0.031), 24 (DLPFC = 1.40 ± 1.24, Sham = 5.03 ± 3.87, P = 0.008), and 48 (DLPFC = 1.47 ± 1.41, Sham = 5.87 ± 4.34, P = 0.014) hours post-surgery, whereby M1 stimulation had no effect. No group effect was observed on total anaesthetics, which was mainly provided through the continuous administration of opioids at a set speed for each group. There was also no group or interaction effect on pain ratings. Pump attempts were positively associated with pain ratings in the DLPFC (r = 0.59, P = 0.02) and M1 (r = 0.56, P = 0.03) stimulation.
Our findings show that iTBS to the DLPFC reduces pump attempts for additional anaesthetics following a laparoscopic surgery. However, reduced pump attempts by DLPFC stimulation did not translate into a significantly smaller volume of total anaesthetic, due to the continuous administration of opioids at a set speed for each group.
Our findings therefore provide preliminary evidence for iTBS targeting the DLPFC to be used to improve postoperative pain management.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36933324</pmid><doi>10.1016/j.clinph.2023.02.174</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0039-7306</orcidid><orcidid>https://orcid.org/0000-0002-5547-3361</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1388-2457 |
| ispartof | Clinical neurophysiology, 2023-05, Vol.149, p.81-87 |
| issn | 1388-2457 1872-8952 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2801977170 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Analgesics DLPFC Double-Blind Method Humans Motor cortex Pain, Postoperative - diagnosis Pain, Postoperative - drug therapy Postoperative pain Prefrontal Cortex - physiology TBS Transcranial Magnetic Stimulation - methods |
| title | Analgesic efficacy of theta-burst stimulation for postoperative pain |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-18T00%3A27%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Analgesic%20efficacy%20of%20theta-burst%20stimulation%20for%20postoperative%20pain&rft.jtitle=Clinical%20neurophysiology&rft.au=Cheng,%20Ming&rft.date=2023-05&rft.volume=149&rft.spage=81&rft.epage=87&rft.pages=81-87&rft.issn=1388-2457&rft.eissn=1872-8952&rft_id=info:doi/10.1016/j.clinph.2023.02.174&rft_dat=%3Cproquest_cross%3E2801977170%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2801977170&rft_id=info:pmid/36933324&rft_els_id=S1388245723002213&rfr_iscdi=true |