Purpose : To review the published literature concerning the treatment of painful conditions using devices that deliver electrical stimulation to nervous structures. The review briefly surveys the results obtained using surface electrodes ('TENS') as well as implanted devices. Method : The method used is a critical review of the important published literature up to mid-1999. References were obtained using Medline and the keywords 'pain', together with 'electrical', 'stimulation', 'neurostimulation' or 'TENS'. Results : Electrical stimulation has been found to be of potential benefit in the management of a range of painful conditions. Adequately controlled trials of electrical stimulation are often difficult to achieve. Implanted devices tend to be used in the more severe intractable pain conditions. It is likely that there is more than one mechanism of action. The mechanisms of action are however still often poorly understood, even though historically theoretical and experimental advances in the understand...

Electrical stimulation in the treatment of pain

Interference of the monitored or recorded electrocardiogram is common within operating room and intensive care unit environments. Artifactual signals, which corrupt the normal cardiac signal, may arise from internal or external sources. Electrical devices used in the clinical setting can induce artifacts by various different mechanisms. Newer diagnostic and therapeutic modalities may generate artifactual changes. These artifacts may be nonspecific or may resemble serious arrhythmia. Clinical signs, along with monitored waveforms from other simultaneously monitored parameters, may provide the clues to differentiate artifacts from true changes on the electrocardiogram. Simple measures, such as proper attention to basic principles of electrocardiographic measurement, can eliminate some artifacts. However, in persistent cases, expert help may be required to identify the precise source and minimize interference on the electrocardiogram. Technological advancements in processing the electrocardiographic signal may be useful to detect and eliminate artifacts. Ultimately, an improved understanding of the artifacts generated by equipment, and their identifying characteristics, is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.

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Equipment-related electrocardiographic artifacts: causes, characteristics, consequences, and correction.

Chronic pelvic pain is a heterogeneous condition that often requires multiple physician visits and various treatments prior to achieving an acceptable management strategy. Neuromodulation has been used to treat chronic pelvic pain that has failed other therapies. Numerous modalities of neuromodulation have been used to alleviate chronic pelvic pain with promising results. Numerous modalities of neuromodulation have demonstrated efficacy in the management of pelvic pain. Further investigation is needed to elucidate the most effective treatment modality and to identify the patients who would benefit most from this therapy.

Neuromodulation for Chronic Pelvic Pain.

THE AORTA: Aortic Aneurysm, Trauma, and Dissection

https://www.internationaljournalofcardiology.com/article/S0167-5273(02)00355-8/pdf

Differential electrocardiographic artifact from implanted spinal cord stimulator

A patient with previous actual atrial flutter had what appeared to be atrial flutter seen on Holter monitoring during treatment with a transcutaneous electrical nerve stimulation (TENS) unit. This proved to be artifact caused by the unit rather than a true arrhythmia. The artifact was reproduced in a normal volunteer by application of a TENS unit.

Pseudoatrial flutter: artifact simulating atrial flutter caused by a transcutaneous electrical nerve stimulator (TENS).

An 18-year-old patient underwent repair of traumatic aortic pseudoaneurysm. Postoperatively, the physical examination showed hypertension with 30 mm Hg gradient between the upper and lower extremities. Doppler echocardiographic evaluation demonstrated a new (secondary) aortic coarctation at the site of the repair. Transesophageal echocardiography revealed the detailed anatomy and the cross-sectional area of the coarctation.

Steven H. Weitz

Papers

Pseudoatrial flutter: artifact simulating atrial flutter caused by a transcutaneous electrical nerve stimulator (TENS).

Echocardiographic diagnosis of secondary coarctation complicating the repair of a traumatic pseudoaneurysm of the aorta.

PACU AND ICU CARE: Evaluation and Management of Postoperative Cardiovascular Complications