Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Update on Interventional Management of Neuropathic Pain: A Delphi Consensus of the Spanish Pain Society Neuropathic Pain Task Force

Version 1 : Received: 24 March 2022 / Approved: 25 March 2022 / Online: 25 March 2022 (07:41:03 CET)

A peer-reviewed article of this Preprint also exists.

Serrano-Afonso, A.; Gálvez, R.; Paramés, E.; Navarro, A.; Ochoa, D.; Pérez-Hernández, C. Update on Interventional Management of Neuropathic Pain: A Delphi Consensus of the Spanish Pain Society Neuropathic Pain Task Force. Medicina 2022, 58, 627. Serrano-Afonso, A.; Gálvez, R.; Paramés, E.; Navarro, A.; Ochoa, D.; Pérez-Hernández, C. Update on Interventional Management of Neuropathic Pain: A Delphi Consensus of the Spanish Pain Society Neuropathic Pain Task Force. Medicina 2022, 58, 627.

Journal reference: Medicina 2022, 58, 627
DOI: 10.3390/medicina58050627

Abstract

Interventional management of neuropathic pain (NP) is available to the many patients who do not attain satisfactory outcomes with pharmacotherapy, but evidence supporting this is sparse and fragmented. We attempted to summarize and critically appraise the existing data to identify strategies that yield maximum benefit, orient clinicians, and identify areas that merit further investigation. A two-round Delphi survey that involved pain clinic specialists with experience in the research and management of NP was done over an ad hoc 26-item questionnaire prepared by the authors. Consensus on each statement was defined as either at least 80% endorsement or rejection after the second round. Thirty-five and 29 panelists participated in the first and second round, respectively. Consensus was reached in 20 out of 26 statements. There is sufficient basis to treat postherpetic neuralgias and complex regional pain syndromes with progressive levels of invasiveness and failed back surgery syndrome with neuromodulation. Radiculopathies and localized NP could be treated with peripheral blocks and neuromodulation, or pulsed radiofrequency. Non-ablative radiofrequency and non-paresthetic neuromodulation are efficacious and better tolerated than ablative and suprathreshold procedures. A graded approach, from least to most invasive interventions has the potential to improve outcomes in many patients with common refractory NP conditions. Preliminary promising data warrant further research on new indications, and technical advances might enhance the safety and efficacy of current and future therapies.

Keywords

Neuralgia; Interventional Pain Management; Intractable Pain; Delphi Technique; Review

Subject

MEDICINE & PHARMACOLOGY, Anesthesiology

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our diversity statement.

Leave a public comment
Send a private comment to the author(s)
Views 0
Downloads 0
Comments 0
Metrics 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.