Improvement of postoperative analgesia during cancer surgery with Limoge's current: a personal experience.
BACKGROUND
The anesthesiologist took advantage of a personal experience to determine whether transcutaneous cranial electrical stimulation using Limoge's current (TCES-LC) improved the level of postoperative analgesia by potentiating anesthetic agents used during the intra- and postoperative phases. Included were analgesics injected through an epidural thoracic catheter (T8-T9) positioned at the end of an esophagectomy. Another reason for a self-experimentation was to be able to evaluate the psycholeptic effects of TCES-LC to gain a better understanding of the problems linked with pain during treatment.


METHODS
The Limoge' current is bidirectional and consists of a high-frequency biphasic asymmetrical wave composed of modulated, high-frequency (166-kHz) pulse trains with a repetition cycle of 100 Hz. TCES-LC was initiated 2 hours before anesthetic induction without any tranquilizer or other medication. TCES-LC was continuously applied during the entire surgical procedure and continued 48 hours postoperatively in the intensive care unit (ICU). As the objective was not to obtain electrical anesthesia, the usual anesthetic protocol was used during surgery.


RESULTS
During the initial 48 postoperative hours with continuous application of TCES-LC (D0-D1), a decrease of the epidural anesthetic dose requirement was observed for ropivacaine, and sufentanil (-25% and -60% respectively). A similar decrease in these medications was also measured on day 2 (D2), while TCESLC was terminated. This decrease was amplified day 3 (D3) for both ropivacaine and sufentanil (-50% and -73% respectively). On day 4 (D4) the epidural anesthetics were totally suppressed (1 day before the normal conventional schedule planned for by the ICU physician with this type surgery).


CONCLUSIONS
Future clinical trials need to be conducted to show the significant advantages of TCES-LC in alternative and complementary medicine.
Rene Descartes University of Paris, France. alimoge@wanadoo.fr
Aimé
A
Limoge
Florence
F
Dixmerias-Iskandar
D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003289:Convalescence; D004566:Electrodes; D004580:Electronarcosis / Q000379:methods*; D005602:France; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*
D000700:Analgesics