Sensory Testing in Patients With Postthoracotomy Pain Syndrome: Part 1: Mirror-Image Sensory Dysfunction

TY - JOUR

T1 - Sensory Testing in Patients With Postthoracotomy Pain Syndrome

T2 - Part 1: Mirror-Image Sensory Dysfunction

AU - Werner, Mads Utke

AU - Ringsted, Thomas K

AU - Kehlet, Henrik

AU - Wildgaard, Kim

PY - 2013/9

Y1 - 2013/9

N2 - OBJECTIVES:: Mirror-image sensory dysfunction (MISD) has not been systematically characterized in persistent postoperative pain. METHODS:: The presence of MISD was evaluated with standardized stimuli, in preoperative patients scheduled for a thoracotomy (n=14) and in patients with postthoracotomy pain syndrome [PTPS (n=14)]. The primary outcome was investigation of the areas of sensory dysfunction, evaluated twice by dynamic sensory mapping with metal rollers and a brush. RESULTS:: In PTPS patients, sensory dysfunction was present on the surgical side, and in 12 of 14 patients MISD was demonstrated. The total areas of sensory dysfunction [median (interquartile range)] were: day 1, 500 (289 to 636) cm and 60 (0 to 379) cm on the surgical and nonsurgical side (P0.5). The agreement between test-retest assessments was fair to excellent on the surgical side but poor on the nonsurgical side. None of the PTPS patients experienced mirror pain. DISCUSSION:: MISD is a common finding in PTPS patients and deserves further study involving mechanism and clinical implications.

AB - OBJECTIVES:: Mirror-image sensory dysfunction (MISD) has not been systematically characterized in persistent postoperative pain. METHODS:: The presence of MISD was evaluated with standardized stimuli, in preoperative patients scheduled for a thoracotomy (n=14) and in patients with postthoracotomy pain syndrome [PTPS (n=14)]. The primary outcome was investigation of the areas of sensory dysfunction, evaluated twice by dynamic sensory mapping with metal rollers and a brush. RESULTS:: In PTPS patients, sensory dysfunction was present on the surgical side, and in 12 of 14 patients MISD was demonstrated. The total areas of sensory dysfunction [median (interquartile range)] were: day 1, 500 (289 to 636) cm and 60 (0 to 379) cm on the surgical and nonsurgical side (P0.5). The agreement between test-retest assessments was fair to excellent on the surgical side but poor on the nonsurgical side. None of the PTPS patients experienced mirror pain. DISCUSSION:: MISD is a common finding in PTPS patients and deserves further study involving mechanism and clinical implications.

U2 - 10.1097/AJP.0b013e318277b646

DO - 10.1097/AJP.0b013e318277b646

M3 - Journal article

C2 - 23328340

SN - 0749-8047

JO - Clinical Journal of Pain

JF - Clinical Journal of Pain

ER -