{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:13:07Z","timestamp":1792804387664,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T00:00:00Z","timestamp":1493078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative pain control is an important factor in determining recovery in total knee arthroplasty (<jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>).The aim of the study was to assess the efficacy of 4 sessions of transcranial direct current stimulation (<jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content>) over primary motor cortex (M1) in patients undergoing unilateral <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials<\/jats:title><jats:p>Fifty patients undergoing <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content> were included in the study. They were divided randomly into two groups (25 patients for each, using closed envelopes): real <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> (2\u00a0mA, 20\u00a0min, with anodal stimulation applied over M1 postoperative for 4 consecutive days) and sham <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content>. Opioid consumption was titrated by an anaesthesiologist during the study period and was used as primary outcome. As a secondary outcome, patients were evaluated using Visual Analogue Scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) and Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (<jats:styled-content style=\"fixed-case\">LANSS<\/jats:styled-content>) at baseline, then the 1st, 2nd, 3rd and 4th days after operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant difference between real and sham <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> in any rating scales at baseline. The opioid consumption and <jats:styled-content style=\"fixed-case\">LANSS<\/jats:styled-content> scores decreased more in patients who received real <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> over the course of the treatment than sham <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content>. Real <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> was associated with 59% reduction in the titrated analgesia. There was no significant difference between groups (time\u00a0\u00d7\u00a0groups interaction) in the VAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Since the <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> was constant, repeated sessions of anodal <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> over M1 with an extra\u2010cephalic cathodal electrode can achieve the same degree of analgesia with less opioid consumption over the postoperative days after <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>. Thus, <jats:styled-content style=\"fixed-case\">tDCS<\/jats:styled-content> is a promising tool in the field of postoperative analgesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The data of the present study suggest that four sessions of transcranial direct current brain stimulation over motor cortex could reduce morphine consumption and pain perception during the postoperative period in total knee arthroplasty.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1034","type":"journal-article","created":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T07:17:06Z","timestamp":1493104626000},"page":"1355-1365","source":"Crossref","is-referenced-by-count":29,"title":["Role of transcranial direct current stimulation on reduction of postsurgical opioid consumption and pain in total knee arthroplasty: Double randomized clinical trial"],"prefix":"10.1002","volume":"21","author":[{"given":"E.M.","family":"Khedr","sequence":"first","affiliation":[{"name":"Neuropsychiatry Department Assiut University Hospital Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.S.A.","family":"Sharkawy","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Assiut University Hospital Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.A.","family":"Attia","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Assiut University Hospital Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.M.","family":"Ibrahim Osman","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Assiut University Hospital Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.M.","family":"Sayed","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Assiut University Hospital Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-006-0733-y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318157233b"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(00)00482-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145707007833"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.03.013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.01.050"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31827e32be"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31826fb302"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2008.09.009"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000317060.43722.a3"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.02.023"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22195"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70032-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.09.001"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00114-1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001525"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-010-2340-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/63.2.189"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14966-5"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968313484808"},{"key":"e_1_2_7_22_1","first-page":"789","article-title":"Anodal transcranial direct current stimulation over the dorsolateral prefrontal cortex improves anorexia nervosa: A pilot study","volume":"32","author":"Khedr E.M.","year":"2014","journal-title":"Restor Neurol Neurosci"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2014.00275"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","unstructured":"Knotkova H. 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