ORIGINAL ARTICLE
Year : 2012  |  Volume : 6  |  Issue : 1  |  Page : 7-10

Postoperative left prefrontal repetitive transcranial magnetic stimulation reduces post-thoracotomy pain


1 Department of Anesthesiology, Faculty of Medicine, Cairo University, Giza, Egypt
2 Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia

Correspondence Address:
Mohamed Bakry
MD, Department of Anaesthesiology, Faculty of Medicine, Cairo University, 12111 Giza
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJCA.0000415931.14020.c8

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Objective

Several recent studies have suggested that repetitive transcranial magnetic stimulation (rTMS) can temporarily reduce the need for analgesia postoperatively. We aimed to determine the effects of prefrontal cortex stimulation using TMS on post-thoracotomy pain.

Methods

Twenty patients who had undergone thoracic surgery were studied. Immediately after surgery, the patients were randomly assigned to receive 20 min of active or sham rTMS (10 Hz, 10-s ON, and 20-s OFF for a total of 4000 pulses). Participants rated pain and mood twice per day using visual analog scale.

Results

Groups were similar at baseline in terms of the BMI, age, mood ratings, pain ratings, surgery duration, time under anesthesia, and surgical anesthesia methods. Active prefrontal rTMS was associated with a 40% reduction in total morphine use compared with sham during the 48 h after surgery. Participants who received active rTMS also reported significantly lower ratings of postoperative pain-on-average and pain-at-its-worst than participants receiving sham.

Conclusion

A single session of postoperative prefrontal rTMS was associated with a reduction in post-thoracotomy pain. This is clinically important because it offers the potential of reducing the need for the postoperative use of analgesia such as morphine. These analgesics are associated with complications (e.g. respiratory depression), especially in patients undergoing thoracotomy for chest diseases.



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