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Prediction of postoperative pain by preoperative nociceptive reponses to heat stimulation

Werner, Mads LU ; Duun, P and Kehlet, H (2004) In Anesthesiology 100(1). p.115-119
Abstract
Background: Despite major advances in the understanding of the neurobiologic mechanisms of pain, the wide variation in acute pain experience has not been well explained. Therefore, the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery. Methods: Twenty patients were studied. The burn injury was induced 6 days before surgery with a contact thermode (12.5 cm(2), 47degreesC for 7 min). The sensory testing, before and 1 h after the injury, included pain score during induction of the burn, secondary hyperalgesta area, thermal and mechanical pain perception, and pain thresholds. Postoperative analgesia consisted of ibuprofen and... (More)
Background: Despite major advances in the understanding of the neurobiologic mechanisms of pain, the wide variation in acute pain experience has not been well explained. Therefore, the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery. Methods: Twenty patients were studied. The burn injury was induced 6 days before surgery with a contact thermode (12.5 cm(2), 47degreesC for 7 min). The sensory testing, before and 1 h after the injury, included pain score during induction of the burn, secondary hyperalgesta area, thermal and mechanical pain perception, and pain thresholds. Postoperative analgesia consisted of ibuprofen and acetaminophen. Pain ratings (visual analog scale) at rest and during limb movement were followed for 10 days after surgery. Results: The burn injury was associated with development of significant hyperalgesia. There was a significant correlation between preoperative pain ratings during the burn injury and early (0-2 days, area under the curve) and late (3-10 days, area under the curve) postoperative dynamic pain ratings during limb movement. Conclusion: The results of this study suggest that the pain response to a preoperative heat injury may be useful in research in predicting the intensity of postoperative pain. These findings may have important implications to identify patients at risk for development of chronic pain and to stratify individuals for investigations of new analgesics. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Anesthesiology
volume
100
issue
1
pages
115 - 119
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000187623200018
  • pmid:14695732
ISSN
1528-1175
language
English
LU publication?
yes
id
7ae92778-0130-4093-beae-d7b6ef88035b (old id 291212)
alternative location
http://www.anesthesiology.org/pt/re/anes/fulltext.00000542-200401000-00020.htm;jsessionid=HhbcHZmQQ1LTFQrQWK1Gdvp3nfdWyHHvTW79wHZ1byCvLXr1mHcp!1899110359!181195628!8091!-1
date added to LUP
2007-10-26 09:52:00
date last changed
2016-04-15 19:04:42
@article{7ae92778-0130-4093-beae-d7b6ef88035b,
  abstract     = {Background: Despite major advances in the understanding of the neurobiologic mechanisms of pain, the wide variation in acute pain experience has not been well explained. Therefore, the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery. Methods: Twenty patients were studied. The burn injury was induced 6 days before surgery with a contact thermode (12.5 cm(2), 47degreesC for 7 min). The sensory testing, before and 1 h after the injury, included pain score during induction of the burn, secondary hyperalgesta area, thermal and mechanical pain perception, and pain thresholds. Postoperative analgesia consisted of ibuprofen and acetaminophen. Pain ratings (visual analog scale) at rest and during limb movement were followed for 10 days after surgery. Results: The burn injury was associated with development of significant hyperalgesia. There was a significant correlation between preoperative pain ratings during the burn injury and early (0-2 days, area under the curve) and late (3-10 days, area under the curve) postoperative dynamic pain ratings during limb movement. Conclusion: The results of this study suggest that the pain response to a preoperative heat injury may be useful in research in predicting the intensity of postoperative pain. These findings may have important implications to identify patients at risk for development of chronic pain and to stratify individuals for investigations of new analgesics.},
  author       = {Werner, Mads and Duun, P and Kehlet, H},
  issn         = {1528-1175},
  language     = {eng},
  number       = {1},
  pages        = {115--119},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Anesthesiology},
  title        = {Prediction of postoperative pain by preoperative nociceptive reponses to heat stimulation},
  volume       = {100},
  year         = {2004},
}