Predictive Value of Transcutaneous Oxygen Tension Measurement in the Indication for Spinal Cord Stimulation in Patients with Peripheral Vascular Disease: Preliminary Results

Thirteen patients (12 males, 1 fe male, mean age 60.5 years) affected by peripheral vascular disease (21 lower limbs: 9 with intermittent clau dication and 12 with rest pain and/or necrosis smaller than 3 cm2) have been studied by means of transcuta neous oxygen tension (TcpO2) mea surements. They had been submitted to spinal cord stimulation (SCS) de vice implant from one day to twenty- two months previously. In 8 patients (15 limbs) implanted from one day to twenty-two months, the TcpO2 index was calculated to evaluate the neuro- stimulator effect on peripheral blood circulation. In 5 patients (6 limbs) studied before definitive implanta tion, preoperative and postoperative TcpO2 measurements were able to predict the SCS efficacy during the temporary trial period: when TcpO2 did not increase immediately (4 limbs), no result was achieved (am putation) ; a TcpO2 increase corre sponded to relief of symptoms (2 limbs). On the basis of this preliminary report, TcpO2 measurement could be useful for predicting SCS efficacy in vascular patients; the possibility of dividing the patients into responders and nonresponders to SCS by TcpO2 measurement represents an impor tant achievement in determining the indication for SCS implant.

[1]  A. Visoná,et al.  Transcutaneous Oxygen Tension (TcPO2) Measurement as a Diagnostic Tool in Patients with Peripheral Vascular Disease , 1988, Angiology.

[2]  C A Carlsson,et al.  Epidural Electrical Stimulation in Severe Limb Ischemia: Pain Relief, Increased Blood Flow, and a Possible Limb‐saving Effect , 1985, Annals of surgery.

[3]  J. González-Darder,et al.  Spinal cord stimulation in peripheral ischemic pain , 1984, PAIN.

[4]  L. Illis,et al.  Spinal cord stimulation in peripheral vascular disease. , 1983, Journal of neurology, neurosurgery, and psychiatry.

[5]  P. Jaszczak,et al.  Estimation of Blood Flow in Transcutaneous PO2 Measurements , 1983, Acta anaesthesiologica Scandinavica.

[6]  W. Shoemaker,et al.  Use of a Transcutaneous PO2 Regional Perfusion Index to Quantify Tissue Perfusion in Peripheral Vascular Disease , 1983, Annals of surgery.

[7]  F L Golbranson,et al.  Transcutaneous PO2 measurements in health and peripheral arterial occlusive disease. , 1982, Surgery.

[8]  D. M. Dooley,et al.  Modification of blood flow to the extremities by electrical stimulation of the nervous system. , 1976, Southern medical journal.

[9]  A. Cook Electrical stimulation in multiple sclerosis. , 1976, Hospital practice.

[10]  A. Cook,et al.  Vascular disease of extremities. Electric stimulation of spinal cord and posterior roots. , 1976, New York state journal of medicine.

[11]  J. Mortimer,et al.  Electrical Inhibition of Pain by Stimulation of the Dorsal Columns: Preliminary Clinical Report , 1967, Anesthesia and analgesia.

[12]  D. Fiume Spinal cord stimulation in peripheral vascular pain. , 1983, Applied neurophysiology.