Chronic pain in thoracotomy

2012 ◽  
Vol 3 (3) ◽  
pp. 188-188
Author(s):  
J.S. Springer ◽  
B. Johnsen ◽  
A. Hojsgaard ◽  
T.S. Jensen ◽  
L. Nikolajsen
Keyword(s):  
Chronic Pain ◽  
Sensory Nerve ◽  
Nerve Damage ◽  
Research Network ◽  
Sensory Testing ◽  
Acute Postoperative Pain ◽  
German Research ◽  
Intercostal Nerves ◽  
Danish Study

Abstract Background/aims Chronic pain is frequent after thoracotomy (Wildgaard et al., 2009; Guastella et al., 2011). According to a recent Danish study with a follow-up period of 22 months, 33% of the patients developed pain after thoracotomy, and 4–12% of the patients experienced severe pain (Wildgaard et al., 2011). The mechanisms underlying chronic pain after surgery are not fully known, but several risk factors have been identified, e.g. intraoperative nerve damage and acute postoperative pain (Kehlet et al., 2006). A few studies have suggested a correlation between nerve damage during surgery and the development of pain after thoracotomy (Benedetti et al., 1997, 1998; Rogers et al., 2002). We plan to investigate if intraoperative nerve damage is responsible for the development of pain and sensory abnormalities after thoracotomy. Methods Sixty individuals with normal sensibility on the thorax will be included preoperatively. Motor and sensory nerve conduction studies (NCS) will be performed during surgery. Post-surgical follow-up with questionnaires and bilaterally Quantitative Sensory Testing (QST) on the thorax will be performed according to the protocol of the German Research Network on Neuropathic Pain (DFNS). Before implementing the neurophysiological measurements in humans, they have been tested in pigs. Results Neurophysiological measurements in pigs have shown that it is possible to do NCSs on both motor and sensory intercostal nerves, suggesting that measurements are possible in humans. Inclusion of patients is pending. Conclusion The preliminary results will be presented at the congress.

scholarly journals Sympathetic and sensory nerve fiber function in multiple system atrophy and idiopathic Parkinson’s disease

2021 ◽  
Author(s):  
Heidrun H. Krämer ◽  
Cora Rebhorn ◽  
Christian Geber ◽  
Frank Birklein
Keyword(s):  
Detection Threshold ◽  
Sensory Nerve ◽  
Research Network ◽  
Sensory Testing ◽  
Sympathetic Function ◽  
Autonomic Testing ◽  
German Research ◽  
Pain Sensitization ◽  
Mechanical Detection ◽  
Mechanical Pain Thresholds

Abstract Objective To explore small fiber somatosensory and sympathetic function in PD and MSA. Methods We recruited 20 PD patients (7 women, median age 65.5 years; IQR 54.75–70.0), 10 MSA patients (4 women; median age 68 years; IQR 66.25–74.0), and 10 healthy subjects (HC; 4 women, median age 68; IQR 59.0–71.0 years). Autonomic testing included forehead cooling, intradermal microdialysis of norepinephrine (NE; 10–5; 10–6; 10–7; and 10–8), and orthostatic hypotension (OH); somatosensory testing included quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain (DFNS). Results OH occurred more frequently in PD (p = 0.018) and MSA (p = 0.002) compared to HC. Vasoconstriction responses were stronger in PD compared to MSA during forehead cooling (p = 0.044) and microdialysis of physiologically concentrated NE solutions (10–7; 10–8; p = 0.017). PD and MSA had impaired cold (PD: p < 0.01; MSA: p < 0.05) and warm detection thresholds (PD and MSA, both p < 0.05). The mechanical detection threshold was higher in PD (p < 0.01). Conversely, mechanical pain thresholds were decreased in PD and MSA (both p < 0.001), indicating mechanical hyperalgesia. Conclusion In contrast to MSA, we found evidence of peripheral adrenoreceptor hypersensitivity in PD, probably caused by peripheral sympathetic denervation. Sensory testing revealed peripheral neuropathy and central pain sensitization in PD and MSA. Jointly, our data demonstrate autonomic and somatosensory dysfunction in PD and MSA.

scholarly journals Quantitative Sensory Testing and Current Perception Threshold Testing in Patients With Chronic Pain Following Lower Extremity Fracture

2017 ◽  
Vol 20 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Mari A. Griffioen ◽  
Joel D. Greenspan ◽  
Meg Johantgen ◽  
Kathryn Von Rueden ◽  
Robert V. O’Toole ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Lower Extremity ◽  
Quantitative Sensory Testing ◽  
Sensory Nerve ◽  
Sensory Testing ◽  
Perception Threshold ◽  
Current Perception Threshold ◽  
Lower Extremity Fracture ◽  
Threshold Testing ◽  
Chronic Pain Conditions

Background: Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. Purpose: To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. Method: This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. Results: A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. Conclusion: This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.

Chronic pain in children after cardiac surgery via sternotomy

2013 ◽  
Vol 24 (5) ◽  
pp. 893-899 ◽  
Author(s):  
Mette H. Lauridsen ◽  
Anders D. Kristensen ◽  
Vibeke E. Hjortdal ◽  
Troels S. Jensen ◽  
Lone Nikolajsen
Keyword(s):  
Chronic Pain ◽  
Cardiac Surgery ◽  
Quantitative Sensory Testing ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Sensory Testing ◽  
Sensory Abnormalities ◽  
Scar Area ◽  
Post Operative Pain

AbstractIntroductionChronic pain is common after sternotomy in adults with reported prevalence rates of 20–50%. So far, no studies have examined whether children develop chronic pain after sternotomy.Material and methodsPostal questionnaires were sent to 171 children 10–60 months after undergoing cardiac surgery via sternotomy at the age of 0–12 years. The children were asked to recall the intensity and duration of their post-operative pain, if necessary with the help from their parents, and to describe the intensity and character of any present pain. Another group of 13 children underwent quantitative sensory testing of the scar area 3 months after sternotomy.ResultsA total of 121 children, median (range) age 7.7 (4.2–16.9) years, answered the questionnaire. Their age at the time of surgery was median (range) 3.8 (0–12.9) years, and the follow-up period was median (range) 4 (0.8–5.1) years. In all, 26 children (21%) reported present pain and/or pain within the last week located in the scar area; in 12 (46%) out of the 26 children, the intensity was ≥4 on a numeric rating scale (0–10). Quantitative sensory testing of the scar area revealed sensory abnormalities – pinprick hyperalgesia and brush and cold allodynia – in 10 out of 13 children.ConclusionChronic pain after cardiac surgery via sternotomy in children is a problem that should not be neglected. The pain is likely to have a neuropathic component as suggested by the sensory abnormalities demonstrated by quantitative sensory testing.

Reliability of orofacial quantitative sensory testing for pleasantness and unpleasantness

Cephalalgia ◽  
2020 ◽  
Vol 40 (11) ◽  
pp. 1191-1201
Author(s):  
Pankaj Taneja ◽  
Camilla Krause-Hirsch ◽  
Stine Laursen ◽  
Caroline Juul Sørensen ◽  
Håkan Olausson ◽  
...  
Keyword(s):  
Quantitative Sensory Testing ◽  
Intraclass Correlation ◽  
Research Network ◽  
Sensory Testing ◽  
German Research ◽  
Orofacial Region ◽  
The Right ◽  
Testing Protocols ◽  
Healthy Participants ◽  
Somatosensory Function

Background Quantitative sensory testing protocols for perceptions of pleasantness and unpleasantness based on the German Research Network on Neuropathic Pain protocol were recently introduced. However, there are no reliability studies yet published. Aim To evaluate the intra-examiner (test-retest) and inter-examiner reliability for orofacial pleasantness and unpleasantness quantitative sensory testing protocols. Methods Sixteen healthy participants from Aarhus University (11 women and five men, mean age 24, range 21–26 years) contributed. Two examiners were trained in performing the entire quantitative sensory testing protocols for pleasantness and unpleasantness, which included the additional dynamic tactile stimulation test using a goat-hair brush. Each participant underwent examination of both protocols by each examiner (inter-examiner reliability) on day 1. They returned at least 8 days following the testing to be re-examined by one examiner (intra-examiner reliability). All testing was performed on the skin of the right mandibular mental region. The intraclass correlation (ICC) was used to determine reliability. Results For the protocol investigating pleasantness, the majority of parameters had good to excellent intra-examiner (11/14: Intraclass correlation 0.67–0.87) and inter-examiner (13/14: Intraclass correlation 0.62–0.96) reliabilities. Similarly, the protocol investigating unpleasantness had good to excellent intra-examiner (intraclass correlation 0.63–0.99) and inter-examiner (intraclass correlation 0.65–0.98) reliabilities for most (13/15) of the parameters. Conclusion Intra and inter-examiner reliabilities in the majority of quantitative sensory testing parameters (apart from the summation ratio) investigating pleasantness and unpleasantness are acceptable when assessing somatosensory function of the orofacial region. Trial registration: NA

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