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癌症手术后急性神经性疼痛的患病率:一项前瞻性研究。

Prevalence of acute neuropathic pain after cancer surgery: A prospective study.

作者信息

Jain Pn, Padole Durgesh, Bakshi Sumitra

机构信息

Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India.

出版信息

Indian J Anaesth. 2014 Jan;58(1):36-42. doi: 10.4103/0019-5049.126788.

Abstract

BACKGROUND AND AIMS

Acute neuropathic pain (ANP) is an under-recognised and under-diagnosed condition and often difficult to treat. If left untreated, it may further transform into persistent post-operative chronic pain leading to a disability.

AIMS

This prospective study was undertaken on 300 patients to identify the prevalence of ANP in the post-operative period by using a neuropathic pain detection questionnaire tool.

METHODS

This is an open-label study in which patients with six different types of cancer surgeries (Thoracic, gastro-intestinal, gynae/urology, bone/soft-tissue, head and neck and breast subgroups-50 each) were included for painDETECT questionnaire tool on the 2(nd) and 7(th) day surgery.

RESULTS

This study found a 10% point prevalence of ANP. Analysis showed that 25 patients had 'possible' ANP, the maximum from urological cancer surgery (6) followed by thoracic surgery (5). Five patients were found to have 'positive' ANP including 2 groin node dissection, 2 hemipelvectomy and 1 oesophagectomy.

CONCLUSION

Significant relationship between severity of post-operative pain was found with the occurrence of ANP in the post-operative period requiring a special attention to neuropathic pain assessment. Larger studies are required with longer follow-up to identify accurately the true prevalence and causative factors of ANP after surgery.

摘要

背景与目的

急性神经性疼痛(ANP)是一种未得到充分认识和诊断的疾病,且常常难以治疗。若不加以治疗,它可能会进一步转变为持续性术后慢性疼痛,导致残疾。

目的

本前瞻性研究对300例患者进行,通过使用神经性疼痛检测问卷工具来确定术后ANP的患病率。

方法

这是一项开放标签研究,纳入了接受六种不同类型癌症手术的患者(胸部、胃肠、妇科/泌尿科、骨/软组织、头颈和乳腺亚组,各50例),在术后第2天和第7天使用疼痛检测问卷工具。

结果

本研究发现ANP的时点患病率为10%。分析显示,25例患者有“可能的”ANP,其中泌尿外科癌症手术患者最多(6例),其次是胸科手术(5例)。发现5例患者有“肯定的”ANP,包括2例腹股沟淋巴结清扫术、2例半骨盆切除术和1例食管切除术。

结论

术后疼痛的严重程度与术后ANP的发生之间存在显著关联,需要特别关注神经性疼痛评估。需要进行更大规模、随访时间更长的研究,以准确确定手术后ANP的真实患病率和病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3381/3968649/d62cb1fcf5f0/IJA-58-36-g001.jpg

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