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Preoperative scar hyperalgesia is associated with post-operative pain in women undergoing a repeat Caesarean delivery

Ortner, C.M. ; Granot, M. ; Richebé, P. ; Cardoso, M. ; Bollag, L. ; Landau, R.

European journal of pain, 2013-01, Vol.17 (1), p.111-123 [Periódico revisado por pares]

England: Blackwell Publishing Ltd

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Título:
Preoperative scar hyperalgesia is associated with post-operative pain in women undergoing a repeat Caesarean delivery
Autor: Ortner, C.M. ; Granot, M. ; Richebé, P. ; Cardoso, M. ; Bollag, L. ; Landau, R.
Assuntos: Acute Pain - drug therapy ; Acute Pain - epidemiology ; Acute Pain - physiopathology ; Adolescent ; Adult ; Analgesics, Opioid - administration & dosage ; Cesarean Section, Repeat - adverse effects ; Cesarean Section, Repeat - statistics & numerical data ; Chronic Pain - drug therapy ; Chronic Pain - epidemiology ; Chronic Pain - physiopathology ; Cicatrix - epidemiology ; Cicatrix - physiopathology ; Female ; Humans ; Hyperalgesia - drug therapy ; Hyperalgesia - epidemiology ; Hyperalgesia - physiopathology ; Incidence ; Morphine - administration & dosage ; Pain, Postoperative - drug therapy ; Pain, Postoperative - epidemiology ; Pain, Postoperative - physiopathology ; Postsynaptic Potential Summation - physiology ; Predictive Value of Tests ; Pregnancy ; Risk Factors ; Young Adult
É parte de: European journal of pain, 2013-01, Vol.17 (1), p.111-123
Notas: ark:/67375/WNG-9DSS6NGF-H
istex:2B90015E5424E0C70C7969E5247D6CE59A5E810B
ArticleID:EJP171
Funding sources
Work received departmental funding.
Conflicts of Interest
There are no conflicts of interest.
ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Background Over 1.4 million Caesarean deliveries are performed annually in the United States, out of which 30% are elective repeat procedures. Post‐operative hyperalgesia is associated with an increased risk for persistent post‐surgical pain; however, there are no data on whether residual scar hyperalgesia (SHA) from a previous Caesarean delivery (CD) persists until the next delivery. We hypothesized that residual SHA may be present in a substantial proportion of women and is associated with increased post‐operative pain. Methods One hundred and sixty‐three women scheduled for a repeat CD under spinal anaesthesia were enrolled into the study. Mechanical temporal summation (mTS) and SHA index were measured preoperatively. SHA was considered present when the index was >0. Post‐operative pain scores at 12, 24 and 48 h and wound hyperalgesia (WHA) at 48 h were recorded. Results SHA was present in 67 women 41% with a median SHA index of 0.42 (Q 25 = 0.25; Q 75 = 1.1, range 0.03–4.25). Women with SHA had overall higher post‐operative pain scores and SHA was correlated with preoperative mTS (r = 0.164, p < 0.05), post‐operative pain severity (r = 0.25, p < 0.002) and WHA at 48 h (r = 0.608, p < 0.001). Severe pain (visual analogue pain scale‐S48 ≥ 7, n = 20) was predicted with a sensitivity and specificity of 60% and 62%, respectively. Positive predictive value was 18% and negative predictive value was 92%. Conclusions Preoperative SHA is present in 41% of women scheduled for repeat CD and is associated with increased mTS and post‐operative pain. Screening for preoperative SHA may predict women at risk for increased post‐operative pain, and guide post‐operative analgesia to include anti‐hyperalgesic drugs.
Editor: England: Blackwell Publishing Ltd
Idioma: Inglês

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Preoperative scar hyperalgesia is associated with post-operative pain in women undergoing a repeat Caesarean delivery

Ortner, C.M. ; Granot, M. ; Richebé, P. ; Cardoso, M. ; Bollag, L. ; Landau, R.

England: Blackwell Publishing Ltd

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