Single Center Experience of Spinal
Cord Stimulation in Chronic
Abdominal Pain
James R. Bruns, MD; Hammam H. Akbik, MD, Harsh Sachdeva, MD
Department of Anesthesiology, Pain Medicine Division, University of
Cincinnati College of Medicine, Cincinnati, OH
Introduction
• Recent evidence has demonstrated the
utility of spinal cord stimulation (SCS) in
chronic abdominal pain. (1) We reviewed
the results of SCS in chronic refractory
abdominal pain at our single center to
determine if they were comparable to
published results.
Methods
• All patients treated with SCS for chronic abdominal pain
between 2008-2010 at the University of Cincinnati Pain
Management Center were evaluated.
• Patient reported pain improvement scores were recorded
along with opioid use.
• Opioid use was converted into oral morphine equivalents
using GlobalRPH online narcotic calculator. (2)
• Follow up of pts ranged from 4 months to 1 year
Results
• 11 consecutive patients
were identified that
received SCS for
abdominal pain.
– Etiology of pain included:
pancreatitis (n=4), adhesions
(n=2) and chronic abdominal
pain nos (n =5).
– All patients initially underwent
a trial lasting from 5 to 7 days.
– 2 octad leads were placed in
the T6-T8 region during both
the trial and implant
Results
– Of the 11 patients, 8 had a positive response and
were ultimately implanted with a permanent
stimulator.
– The 3 patients that did not receive permanent implant
reported minimal improvements in their pain (0-10%).
– The 8 that had a positive response reported pain
improvement scores that averaged 83% (range 50100%).
– Opioid use decreased 77% (range 49%-100%), from
112 mg (range 20-288 mg) to 16 mg (range 0-60 mg)
opioid equivalents.
Results
Conclusions
• Our results are consistent with prior studies that
suggest SCS is a viable option for treatment
refractory abdominal pain.
• Most of our patients reported significant
decreases in both reported pain scores and
opioid use.
• Three of the 8 patients were completely weaned
of their opioids, one of which was using 288 mg
of oral morphine equivalents daily.
References
1.Kapural L, Nagem H, Tlucek H, Sessler D
I. Spinal cord stimulation for chronic
visceral abdominal pain. Pain Medicine
2010 11: 347–355.
2.http://www.globalrph.com/narcoticonv.htm
Questions?