Investigation of central pain processing in postoperative shoulder pain and disability.
Investigation of central pain processing in postoperative shoulder pain and disability.
复制标题
术后肩痛和残疾中枢疼痛处理的研究。
DOI：
10.1097/ajp.0000000000000029
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
George,StevenZ
中科院分区：
文献类型：
--
作者：
Valencia,Carolina;Fillingim,RogerB;Bishop,Mark;Wu,SamuelS;Wright,ThomasW;Moser,Michael;Farmer,Kevin;George,StevenZ
背景：中枢疼痛处理的测量方法，如条件性疼痛调制和阈上热痛反应（SHPR）已被描述为评估中枢疼痛调制机制的不同组成部分。中枢疼痛处理可能在术后疼痛的发展中发挥作用，然而，条件性疼痛调制和SHPR在解释术后临床疼痛和残疾的作用尚不清楚。方法：78例临床肩痛患者被纳入本研究。在肩关节手术前、手术后3个月和6个月对患者进行检查。主要结果的措施是疼痛强度和上肢disability.Results：分析显示，变化分数（基线-3个月）的第五疼痛等级的SHPR占一个显着量的方差在6个月的术后临床疼痛强度和残疾后，年龄，性别，术前疼痛强度，和相关的心理factorswere considered.Conclusions：本研究表明，中枢疼痛处理的基线措施不预测6个月的术后疼痛结果。相反，SHPR的3个月变化可能是过渡到术后6个月疼痛和残疾结局升高的相关因素。在肩痛患者中，3个月中枢疼痛处理指标的变化可能是术后6个月疼痛和残疾评分升高的相关因素。
Background:Measures of central pain processing like conditioned pain modulation and suprathreshold heat pain response (SHPR) have been described to assess different components of central pain modulatory mechanisms. Central pain processing potentially plays a role in the development of postsurgical pain, however, the role of conditioned pain modulation and SHPR in explaining postoperative clinical pain and disability is still unclear.Methods:Seventy-eight patients with clinical shoulder pain were included in this study. Patients were examined before shoulder surgery, at 3 months, and 6 months after surgery. The primary outcome measures were pain intensity and upper extremity disability.Results:Analyses revealed that the change score (baseline-3 mo) of fifth pain rating of SHPR accounted for a significant amount of variance in 6-month postsurgical clinical pain intensity and disability after age, sex, preoperative pain intensity, and relevant psychological factors were considered.Conclusions:The present study suggests that baseline measures of central pain processing were not predictive of 6-month postoperative pain outcome. Instead, the 3-month change in SHPR might be a relevant factor in the transition to an elevated 6-month postoperative pain and disability outcomes. In patients with shoulder pain, the 3-month change in a measure of central pain processing might be a relevant factor in the transition to elevated 6-month postoperative pain and disability scores.