Liste-6

DOES LONG-TERM HOME TREATMENT WITH EPIDURAL ANALGESIA EFFECT LATER SPINAL CORD STIMULATION (SCS) IN PATIENTS WITH OTHERWISE INTRACTABLE ANGINA PECTORIS.

Andersen C and Hole P

The purpose of this present investigation was to study whether patients previously treated with epidural injections had more frequent electrode migration, higher stimulation needs and less effect of the SCS treatment.

Method? In a prospective study with minimum 4 year follow‑up period, we evaluated whether previous thoracic epidural analgesi influences the efficacy of spinal cord stimulation (SCS) in patients with intractable angina pectoris. The study group comprised 53 patients (10 women, 43 men) with a mean age of 61 (range: 44-75) years, and a mean duration of angina pectoris of 8.9 (range: 3-22) years. All had been treated with opiates daily because of anginal pain. 26 of the patients had epidural catheters for a mean time of one year.

Results: The number of myocardial infarctions or cardiac death in the follow-up period showed no significant differences (p = 0.68). Stimulation requirements for previous epidurally treated patients were 3.0 Volt. Control group patients' requirements were 4.0 Volts (p = 0.09). In conclusion, we found that SCS treatment in patients previously treated with epidural catheters differs in no way from patients not previously treated with epidural catheters.

Conclusion: The stimulation demand (p = 0.09), frequency of electrode migrations

(p = 0.46) and pain reducing effect (p = 0. 16) was not different for the group of patients who previously was treated with epidural catheters for longer periods (1-36 months). However, the sample size studied would only be adequate to detect a significant difference of 80% between the two treatment groups, with 80% likelihood (1-beta) with type 1 error of p < 0.05.