A pain in the pocket: Prevalence of pocket pain in patients with implantation of neuromodulation systems: A retrospective study

J. García Baos , Á. Huete Marañés , Á. Mingote , A. Mendiola de la Osa , M. Herrero Trujillano , C. Ágreda García , S.H. Martínez Rodríguez , J. García Fernández
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Abstract

Introduction

Implantable pulse generator (IPG) is a neurostimulation therapy mediated by electrodes and surgically implanted in a subcutaneous "pocket" used for the control of numerous pathologies. This study examines both the prevalence of pain associated with IPG implantation ("pain pocket syndrome") and its associated characteristics.

Materials and methods

56 patients with an IPG were included in the study. A health questionnaire was conducted to determine the presence of pain associated with the pocket and its neuropathic characteristics, as well as associated aesthetic concerns, location, situations that accentuate or alleviate pain, medications used for baseline and pocket pain control and other factors associated.

Results

Pain in the area of implantation of the IPG had a prevalence of 52.6% of patients (n = 27), in our sample, with a mean score on the visual analogic scale (VAS) of 4.9 points [3.9–5.8 points], with neuropathic characteristics in 53.3% (n = 16) of the patients with pain, with differences between the mean VAS score of the female (5.5 [4.3–5.8 points]) and males (3.5 points [2.1–4.9 points]) (p = 0.04).

Conclusion

Pocket pain is a condition with a higher prevalence than described in previous studies, being of a higher intensity in females, involving a moderate pain in the area of implantation of the neuromodulating therapy. This pain has neuropathic characteristics and could require a repositioning intervention. Hence, more studies in this field should be carried to detect and prevent this syndrome.
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口袋里的疼痛神经调控系统植入患者口袋疼痛的发生率:一项回顾性研究。
简介植入式脉冲发生器(IPG)是一种以电极为媒介的神经刺激疗法,通过手术植入皮下 "口袋",用于控制多种病症。本研究探讨了与 IPG 植入相关的疼痛("口袋疼痛综合征")的发生率及其相关特征。研究人员进行了健康问卷调查,以确定是否存在与囊袋相关的疼痛及其神经病理性特征,以及相关的美学问题、位置、加重或减轻疼痛的情况、用于控制基线和囊袋疼痛的药物及其他相关因素:在我们的样本中,52.6%的患者(n = 27)在植入 IPG 的区域出现疼痛,视觉模拟量表(VAS)的平均值为 4.9 分 [3.9 - 5.8 分],53.3%的患者(n = 16)出现神经病理性疼痛。3%(n = 16)的疼痛患者具有神经病理性特征,女性(5.5 分 [4.3 - 5.8 分])和男性(3.5 分 [2.1 - 4.9 分])的视觉类比量表平均得分存在差异(p = 0.04):窝沟封闭痛的发病率高于以往的研究,女性的发病率更高,神经调节疗法植入区域有中度疼痛。这种疼痛具有神经病理性特征,可能需要重新定位干预。因此,应在这一领域开展更多研究,以检测和预防这种综合征。
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