Severity of Acute Pain After Breast Surgery Is Associated With the Likelihood of Subsequently Developing Persistent Pain
Severity of Acute Pain After Breast Surgery Is Associated With the Likelihood of Subsequently Developing Persistent Pain
复制标题
DOI：
10.1097/ajp.0b013e3181dee988
复制
发表时间：
2010-09-01
影响因子：
2.9
通讯作者：
Shorten, George D.
中科院分区：
文献类型：
--
作者：
Hickey, Oonagh T.;Burke, Siun M.;Shorten, George D.
目的：乳腺癌手术后持续性术后疼痛 (PPSP) 的患病率为 20% 至 52%。神经塑性变化可能在这种疼痛的病因学中发挥作用。本研究的主要目的是探讨乳腺癌手术后急性疼痛与随后发生 PPSP 的可能性之间的关系。方法：28 名接受乳腺癌手术的女性完成了疼痛和焦虑的视觉模拟量表、麦吉尔疼痛问卷（长版）和医院焦虑和抑郁量表。记录镇痛需求和镇痛治疗的副作用。围手术期使用电刺激进行定量感觉测试，并在双侧 T4 皮区和对侧 L5 皮区测量感觉知觉、疼痛知觉和疼痛耐受阈值。对术后 3 个月有和没有 PPSP 的患者的这些参数进行比较。结果：8 名参与者 (28.6%) 报告有 PPSP。随后发生 PPSP 的患者术后 5 天在麦吉尔疼痛问卷中报告的疼痛评分高于未发生 PPSP 的患者（疼痛评分指数，P=0.014；目前疼痛强度，P=0.032）。没有人因持续疼痛而寻求医疗救助。患有和不患有 PPSP 的患者在精神状态（焦虑和抑郁）、镇痛药用量、镇痛治疗的不良反应以及 QST 变化方面相似。讨论：发生 PPSP 的患者在术后第五天比没有发生 PPSP 的患者经历了更严重的疼痛。
Objectives: Persistent postsurgical pain (PPSP) after surgery for breast cancer has a prevalence of 20% to 52%. Neuroplastic changes may play a role in the aetiology of this pain. The principal objective of this study was to examine the relationship between acute pain after surgery for breast cancer and the likelihood of subsequently developing PPSP.Methods: Twenty-eight women undergoing surgery for breast cancer completed visual analogue scales for pain and anxiety, the McGill Pain Questionnaire (long form) and the Hospital Anxiety and Depression Scale. Analgesic requirements and adverse effects of analgesic therapy were noted. Quantitative sensory testing was carried out perioperatively using an electrical stimulus, and the sensation perception, pain perception, and pain tolerance thresholds were measured bilaterally at the T4 dermatomes and at the contralateral L5 dermatome. Patients with and without PPSP 3 months postoperatively were compared in terms of these parameters.Results: Eight participants (28.6%) reported PPSP. Those who subsequently developed PPSP reported greater pain scores on the McGill Pain Questionnaire 5 days postoperatively than those that did not (pain rating index, P=0.014; present pain intensity, P=0.032). None had sought medical attention for their persistent pain. Patients with and without PPSP were similar in terms of mental status (anxiety and depression), analgesic consumption, adverse effects of analgesic therapy, and changes on QST.Discussion: Patients who developed PPSP experienced pain of greater intensity on the fifth postoperative day than those that did not.