Segura-Méndez Bárbara, Planchuelo-Gómez Álvaro, Fuentes-Martín Álvaro, Madeleine Pascal, Guerrero Ángel L, Carrascal Yolanda, Fernández-de-Las-Peñas César
Cardiac Surgery Department, University Clinical Hospital, 47005 Valladolid, Spain.
Imaging Processing Laboratory, Universidad de Valladolid, 47005 Valladolid, Spain.
Life (Basel). 2024 Sep 26;14(10):1233. doi: 10.3390/life14101233.
We aim to evaluate changes in pressure pain sensitivity before and after cardiac surgery using topographical sensitivity maps utilizing a pressure algometer.
Pressure pain thresholds over 17 thoracic points and 4 distant pain-free points were assessed in 70 patients (women: 29, age: 67.5 years), before and at 1, 3, and 7 postoperative days. Thoracic topographical pressure pain sensitivity maps were calculated at all follow-ups. Postoperative pain was recorded at each follow-up on a numerical pain rate scale.
Postoperative pain intensity decreased from 6.4 (SD 1.0) on the first postoperative day to 5.5 (SD 1.9) on the third and to 4.5 (SD 1.7) on the seventh day ( < 0.001). The mixed-model ANOVA revealed that the lowest pressure pain thresholds were observed one day after surgery, increased slightly during follow-up, and were lower at the xiphoid process. Significant negative correlations between postoperative pain intensity and pressure pain thresholds were observed at each time point in thoracic measures (all, < 0.01), but not with pressure pain thresholds from distant pain-free areas.
Postoperative pain after cardiac surgery can be objectively quantified using algometry. Pressure pain hyperalgesia was associated with the intensity of postoperative pain.
我们旨在利用压力痛觉计绘制的地形敏感性图，评估心脏手术前后压力疼痛敏感性的变化。
对70例患者（女性29例，年龄67.5岁）在术前、术后第1天、第3天和第7天评估17个胸部点和4个远处无痛点的压力痛阈。在所有随访中计算胸部地形压力疼痛敏感性图。每次随访时用数字疼痛评分量表记录术后疼痛情况。
术后疼痛强度从术后第1天的6.4（标准差1.0）降至术后第3天的5.5（标准差1.9），并在第7天降至4.5（标准差1.7）（<0.001）。混合模型方差分析显示，术后一天观察到最低的压力痛阈，随访期间略有增加，且剑突处的压力痛阈更低。在胸部测量的每个时间点，术后疼痛强度与压力痛阈之间均存在显著负相关（均<0.01），但与远处无痛区域的压力痛阈无关。
心脏手术后的疼痛可通过痛觉测量法进行客观量化。压力性疼痛过敏与术后疼痛强度相关。
