{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T23:30:24Z","timestamp":1780788624694,"version":"3.54.1"},"reference-count":28,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,8,8]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Habituation and loss of efficacy from spinal cord stimulation are commonly reported. This retrospective analysis investigated rescue of analgesia from spinal cord stimulation failure after implementing a strategy called a stimulation holiday, during which spinal cord stimulation is interrupted for a defined period and subsequently restarted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A 6-year review (June 1, 2016\u2013May 13, 2022) from a tertiary care center was conducted on patients who underwent 10 kHz frequency dorsal column spinal cord stimulation for \u22653 months, experienced loss of efficacy (\u226430%\u2009pain relief or patient self-report of lack of meaningful pain relief), subsequently underwent a stimulation holiday, and then restarted spinal cord stimulation. The primary outcome was comparison of pain relief and responder rate (\u226550% relief in pain intensity) before and after stimulation holiday.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 212 patients, 40 (18.9%) experienced loss of efficacy at a mean follow-up period of 452.7\u00b1326.4\u2009days after stimulator implantation and underwent stimulation holiday. Pain relief was significantly higher 1\u2009month after stimulation holiday (39.4%\u00b128.6%) compared with before stimulation holiday (8.7%\u00b113.0%; mean difference 30.6%, 95% CI 21.9% to 39.3%, paired t-test p&lt;0.001). A significantly higher responder rate (\u226550% relief in pain intensity) was identified after stimulation holiday (57.5%) compared with before stimulation holiday (0%; Fisher\u2019s exact test p&lt;0.001). Associations of superior pain relief and responder rate remained significant at 3 and 6\u2009months after stimulation holiday.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Patients who experience loss of efficacy from spinal cord stimulation habituation could attempt a stimulation holiday rather than abandon therapy. Rescue of analgesia may be achieved after implementing a stimulation holiday and restarting spinal cord stimulation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2022-103881","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T11:21:03Z","timestamp":1660908063000},"page":"722-727","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Stimulation holiday rescues analgesia after habituation and loss of efficacy from 10-kilohertz dorsal column spinal cord stimulation"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4601-9837","authenticated-orcid":false,"given":"Ryan S","family":"D'Souza","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeng 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