首页 | 本学科首页   官方微博 | 高级检索  
检索        


Spinal Cord Stimulation and the Pregnant Patient‐Specific Considerations for Management: A Case Series and Review of the Literature
Authors:Donald J Bernardini MD  Stephen D Pratt MD  Tamara C Takoudes MD  Thomas T Simopoulos MD  MA
Institution:1. Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;2. and;3. Department of Obstetrics and gynecology, Division of Maternal and Fetal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Abstract:Objectives: The use of spinal cord stimulation (SCS) is a form of neuromodulation used to treat chronic pain in those patients who are refractory to conventional medical management. Not uncommonly, SCS can dramatically improve a patient's quality of life, and those who are in the childbearing years may go on to become pregnant. The purpose of this case series is to describe: 1) implantation considerations in women of childbearing age; 2) use of rechargeable systems; 3) the obstetric and anesthetic concerns in patients with spinal cord stimulators; 4) risks of using SCS in the peripartum period. Materials and Methods: Two female patients with complex regional pain syndrome I (CRPS I) who were well managed with SCS became pregnant. In both patients, the leads were placed through the T12/L1 interspace and the generator was placed in the buttock region. In the first patient, the device was deactivated prior to conception and maintained off for the duration of the pregnancy. The second patient became pregnant on two separate occasions, with active SCS for a portion of the first trimester. During her second pregnancy, the patient elected to use of SCS at 30 weeks' gestation. Results: The developing fetuses with intrauterine exposure to SCS were followed out for a minimum of two years and are developmentally normal. The physical presence of the device did not complicate obstetric or anesthetic care. Rechargeable SCS systems were not adversely affected when turned off for the duration of the pregnancy. Conclusion: Implantation of SCS devices in women of childbearing years should take into account the future needs of both obstetric and anesthetic care by avoiding the abdomen and lower lumbar spine whenever possible. There was no appreciable decline of battery capacity in present day constant current rechargeable generators when deactivated for the duration of pregnancy.
Keywords:Electromagnetic fields  obstetric and anesthetic considerations  pregnancy  rechargeable implantable pulse generators  spinal cord stimulation
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号