神经病理性疼痛发生机制 - 1.pptVIP

Can chronic neuropathic pain following thoracic surgery be predictedduring the postoperative period? Introduction 1.Chronic pain following thoracic surgery is common(50%) 2. This pain has a significant impact on patient `s live(40% report that pain is their Worst thing and it limited their daily live) The reason of the chronic pain following thoracic surgery The course is not fully understood But, intercostal nerve damage and subse- quent dysfunction has long been implicated intercostal nerve damage The studies about the chronic neuropathic pain(CNP) Steegers et al. used a questionnaire to determine the incidence of CNP following Thoracic surgery, concluding 53% had neuropathic pain However,these studies were retrospective postal surveys and with no information on the existence of neuropathic pain before the operation The aim of the study 1. The incidence of ANP and CNP 2. hypothesized that the occurrence of ANP Would be associated with CNP characteristics at three months follow-up Methods Prospective ,observational cohort study Include Exclude Validated neuropathic pain screening tools 1.Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) 2. self-complete version(S-LANSS) LANSS Pain scale S-LANSS Pain scale Statistic 1. Relative risks between ANP and CNP with Fisher`s exact test 2. Any possible relationships between CNP and other factors using stepwise logistic regression analysis with the statistical package STATA Result The postoperative LANSS score was performed anaverage of 3 days following Surgery 87 of these 100 patients completed S-LANSS ,of these 87 patients, 19 (22%) had CNP 85 of the 100 patients completed the NRS, 53 (62%) had chronic pain,and of those patients18 (21%) had a pain score of between 5 and 10 on the NRS scale Result Result Result Patients with CNP had higher average LANSS scores during the postoperative period (median=7) than those who didn`t develop chronic pain