3.5. Chronic pain, type unspecified
In a study of the neurochemistry of depression, CES researchers found
that among the patients in their study were 14 who were listed as
unresolved chronic pain patients, and 9 other chronic pain patients
who considered their condition hopeless. Following two weeks of daily
CES treatment, given 20 minutes a day, the 23 chronic pain patients
reported a significant reduction of 44% or more in their pain
intensity [32].
In a survey of clinicians who use the Alpha-Stim CES device in their
pain practice, it was reported that 260 of 286 chronic pain patients
(91%) reported significant relief following CES treatments. Among
those treated for headaches, 136 of 151 patients (90%) re-ported
significant reduction in headache pain, and 245 of 259 patients (95%)
who reported pain related muscle spasms reported significant relief
[33].
4. Studies of anesthetic equivalency
There have been two studies that assessed the equivalency of CES to
various types of anesthetics. In a rather straight forward study in
which he compared CES with various concentrations of N2O, Stanley gave
a group of 90 urological patients and 30 abdominal surgery patients
either 75%, 62.5% or 50% N2O alone or a similar concentration of N2O
plus CES. After 20 minutes of |
treatment, patients were given a painful stimulus with a Kocker clamp
clamped at the second ratchet and applied to their upper, inner thigh
for one minute. Measurements of pain included patient movement,
systolic blood pressure, heart rate, respiratory rate and minute
ventilation.
It was found that CES increased the potency of N2O by approximately
37% at each level, being between 0.3 and 0.4 MAC in analgesic potency
when combined with N2O. The authors also found that the CES group
experienced prolonged analgesia after recovery of consciousness [34].
In a somewhat more elaborate study, CES equivalency to the narcotic
fentanyl was studied on patients undergoing surgery. Fifty patients
who were to undergo urologic operations were divided into two groups
to receive either CES or sham CES in addition to normal anesthetic
procedures. All patients had anesthesia induced with droperidol (0.20
mg/kg IV), diazepam (0.2 mg/kg IV), and pancuronium (0.8 mg/kg IV).
Anesthesia was maintained during the surgical procedure with fentanyl
given in 100 microgram IV increments every three minutes as necessary
to maintain the patient at the required level of anesthesia.
It was found that an average of 33% less fentanyl was required in
patients who simultaneously received CES treatment [35].
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5. Discussion
While the above studies represent an entire range of study design from
open clinical trials to double-blind, placebo-controlled studies, in
every instance treatment with CES has been accompanied by a dramatic
reduction in the perception of pain in every pain category studied.
It is not clear why putting microcurrent electrical stimulation across
the head would reduce pain in the body. While some would point to a
possible increase in endorphins, two studies that looked for this did
not find it, although one did find an increase in serotonin and a
decrease in cholinesterase [32]. The other study found an increase of
MAO-B in blood platelets and an increased concentration of GABA in the
blood following CES treatments, but did not find an increase in
serotonin, dopamine or beta-endorphins in the blood [36].
Pozos' animal studies indicate that CES is apparently effective in
bringing neurotransmitters back into homeostatic balance when that
balance is deliberately disrupted [37]. It could be possible that when
the brain's normal homeostasis has been shifted into a stress pat-tern
over a period of time, an occurrence suggested by Selye's theories to
be somewhat frequent in our day and age [38], CES may be effectively
putting it hack into a pre stress homeostasis, accompanied by a
reduction in stress related hormones such as cortisol, which is known
to play a role in increased pain perception.
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The
Use of Cranial Electrotherapy Stimulation in the Management of Chronic
Pain: A Review