RESUMEN
Peripheral nerve stimulation (PNS), a type of neuromodulatory technique, is increasingly used to treat chronic pain syndromes. PNS has also recently gained popularity as a viable adjunct analgesic modality in acute pain settings, where the practice primarily relies on using boluses or infusion of local anesthetics for nerve blockade, followed by stimulation to extend the analgesia. There is some early promise in PNS for perioperative analgesic control, but considerable obstacles must be addressed before it can be implemented into standard practice. In this daring discourse, we explore the possibilities and constraints of using the PNS paradigm in acute pain.
Asunto(s)
Dolor Agudo , Analgesia , Estimulación Eléctrica Transcutánea del Nervio , Humanos , Dolor Agudo/diagnóstico , Dolor Agudo/terapia , Manejo del Dolor/métodos , Estimulación Eléctrica Transcutánea del Nervio/métodos , Analgesia/métodos , Analgésicos , Nervios PeriféricosRESUMEN
It has been found that reduction of posttraumatic stress symptoms is positively associated with the reduction of postconcussive symptoms. Cortisol is commonly used as a biomarker of stress. Understanding the role of posttraumatic stress and cortisol in symptom reduction has implication for neuropsychological rehabilitation particularly in the context of spontaneous recovery. OBJECTIVE: The aim of the research was to study the effectiveness of EEG neurofeedback training on clinical symptoms, perceived stress, and cortisol in traumatic brain injury (TBI) patients in the context of spontaneous recovery. METHODS: The design was an experimental longitudinal design with the pre-post comparison. The sample comprised 60 patients with the diagnosis of TBI-30 patients in the neurofeedback training (NFT) group and 30 patients in the treatment as usual group (TAU) group. Half of the patients were recruited within 6 months of injury to study the role of spontaneous recovery and the other half were recruited in the 12 to 18 months postinjury phase. Alpha-theta training was given to the NFT group over 20 sessions. Pre and post comparisons were made on clinical symptom rating, perceived stress, and serum cortisol levels. RESULTS: The results indicate significant differences in symptom reporting and perceived stress between the NFT and TAU groups. Significant differences were also seen in cortisol levels with implications for the acute recovery phase. CONCLUSION: Alpha-theta NFT has a beneficial effect on symptom reduction as well as perceived stress. It also has a beneficial effect on levels of serum cortisol, corroborating these findings.