Ferreira Gurian Maria Beatriz, Poli Neto Omero Benedicto, Rosa e Silva Julio Cesar, Nogueira Antonio Alberto, Candido dos Reis Francisco Jose
Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Pain Med. 2015 May;16(5):849-54. doi: 10.1111/pme.12625. Epub 2014 Dec 19.
The objective of this study was to evaluate whether pain thresholds to electrical stimulation of the skin change in the response to treatment in women with chronic pelvic pain (CPP).
Fifty-eight women with persistent pelvic pain for at least 6 months, from a tertiary care setting, were included in this study. All women were evaluated before the therapeutic intervention and at 6 months of multidisciplinary treatment. To estimate the pain threshold, we used transcutaneous electrical nerve stimulation on the anterior surface of the nondominant arm. The intensity of clinical pain was estimated by a visual analog scale and by the McGill questionnaire.
The mean of pain threshold increased from 14.2 to 17.4 after 6 months of treatment (P < 0.0001). The effect sizes of the increase of electrical pain threshold were 0.86 (95% CI, 0.38 to 1.34) in the group with pain reduction and 0.53 (95% CI, -0.08 to 1.15) in the group without pain reduction.
The sensitivity to experimental pain was reduced after 6 months of multidisciplinary treatment for CPP. Our data provided additional evidence of central sensitization in women with CPP.
本研究的目的是评估慢性盆腔疼痛（CPP）女性在接受治疗后，皮肤对电刺激的疼痛阈值是否会发生变化。
本研究纳入了58名来自三级医疗机构、持续盆腔疼痛至少6个月的女性。所有女性在治疗干预前和多学科治疗6个月后均接受评估。为了估计疼痛阈值，我们在非优势手臂的前表面使用经皮电神经刺激。临床疼痛强度通过视觉模拟量表和麦吉尔问卷进行评估。
治疗6个月后，疼痛阈值的平均值从14.2增加到17.4（P < 0.0001）。疼痛减轻组电痛阈值增加的效应大小为0.86（95%CI，0.38至1.34），未减轻组为0.53（95%CI，-0.08至1.15）。
CPP多学科治疗6个月后，对实验性疼痛的敏感性降低。我们的数据为CPP女性中枢敏化提供了更多证据。
