脊髓电刺激（SCS）已被证明有效治疗神经病性疼痛。不幸的是，一些患者报告长期疼痛缓解不足。患者选择对此疗法至关重要，然而，包括SCS试验在内的现有选择技术的预后能力和部署策略备受质疑。在获得美国区域麻醉和疼痛医学协会董事会批准后，成立了一个指导委员会，制定了基于证据的患者选择及SCS试验角色的指南。具有临床专业知识的专业组织代表被邀请参加委员会成员。指导委员会进行了全面的文献综述，并将结果整理成叙述性报告，分发给所有委员会成员。指导委员会制定了七个部分的个人陈述和建议，并在成员间进行投票。采用修订版德尔菲方法，草案以盲目方式发送给每个成员投票。评论将被纳入随后的修订中，以达成共识的投票再次重新分发。共有39项建议的七个部分获得了所有成员的百分百一致赞同。这些部分包括SCS试验的定义和术语，SCS试验的益处，心理社会特征的筛查，患者对SCS疗法和试验的看法，SCS疗法的其他预测因素，SCS试验的进行，以及SCS试验的评价，包括成功的最低标准。建议包括，在行脊髓电刺激植入手术之前，应进行脊髓电刺激试验，除心绞痛外（B级别）。所有患者必须通过客观验证的工具进行心理社会因素的筛查，其中必须包括抑郁症（B级别）。尽管存在一些限制，试验有助于患者选择，并为患者提供体验此疗法的机会。这些建议预计将指导实践医师和其他利益相关者，并不应误认为是实践标准。医师应继续根据个体患者的考虑和喜好做出最佳判断。©美国区域麻醉和疼痛医学协会2023。不得进行商业再利用。由BMJ出版。

Spinal cord stimulation (SCS) has demonstrated effectiveness for neuropathic pain. Unfortunately, some patients report inadequate long-term pain relief. Patient selection is emphasized for this therapy; however, the prognostic capabilities and deployment strategies of existing selection techniques, including an SCS trial, have been questioned. After approval by the Board of Directors of the American Society of Regional Anesthesia and Pain Medicine, a steering committee was formed to develop evidence-based guidelines for patient selection and the role of an SCS trial. Representatives of professional organizations with clinical expertize were invited to participate as committee members. A comprehensive literature review was carried out by the steering committee, and the results organized into narrative reports, which were circulated to all the committee members. Individual statements and recommendations within each of seven sections were formulated by the steering committee and circulated to members for voting. We used a modified Delphi method wherein drafts were circulated to each member in a blinded fashion for voting. Comments were incorporated in the subsequent revisions, which were recirculated for voting to achieve consensus. Seven sections with a total of 39 recommendations were approved with 100% consensus from all the members. Sections included definitions and terminology of SCS trial; benefits of SCS trial; screening for psychosocial characteristics; patient perceptions on SCS therapy and the use of trial; other patient predictors of SCS therapy; conduct of SCS trials; and evaluation of SCS trials including minimum criteria for success. Recommendations included that SCS trial should be performed before a definitive SCS implant except in anginal pain (grade B). All patients must be screened with an objective validated instrument for psychosocial factors, and this must include depression (grade B). Despite some limitations, a trial helps patient selection and provides patients with an opportunity to experience the therapy. These recommendations are expected to guide practicing physicians and other stakeholders and should not be mistaken as practice standards. Physicians should continue to make their best judgment based on individual patient considerations and preferences.© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ.