Pain in 1,000 Women Treated for Breast Cancer A Prospective Study of Pain Sensitivity and Postoperative Pain

被引:92
|
作者
Kaunisto, Mari A. [1 ,2 ]
Jokela, Ritva [3 ]
Tallgren, Minna [3 ]
Kambur, Oleg [3 ]
Tikkanen, Emmi [1 ]
Tasmuth, Tiina [4 ]
Sipila, Reetta [3 ]
Palotie, Aarno [1 ,6 ]
Estlander, Ann-Mari [3 ]
Leidenius, Marjut [5 ]
Ripatti, Samuli [1 ]
Kalso, Eija A. [3 ,7 ,8 ]
机构
[1] Univ Helsinki, Inst Mol Med Finland, Helsinki 00029, Finland
[2] Univ Helsinki, Cent Hosp, Folkhalsan Inst Genet, Folkhalsan Res Ctr, Helsinki 00029, Finland
[3] Univ Helsinki, Cent Hosp, Dept Anaesthesia & Intens Care Med, Helsinki 00029, Finland
[4] Univ Helsinki, Cent Hosp, Dept Oncol, Helsinki 00029, Finland
[5] Univ Helsinki, Cent Hosp, Dept Surg, Helsinki 00029, Finland
[6] Wellcome Trust Sanger Inst, Dept Human Genet, Cambridge, England
[7] Univ Helsinki, Cent Hosp, Dept Anaesthesia Intens Care Med Emergency Med &, Helsinki 00029, Finland
[8] Univ Helsinki, Inst Clin Med, Helsinki 00029, Finland
基金
芬兰科学院;
关键词
POSTCESAREAN SECTION PAIN; PERSISTENT PAIN; RISK-FACTORS; SURGERY; PREDICTION; HEAT; POPULATION; PREVALENCE; PREVENTION; SYMPTOMS;
D O I
10.1097/ALN.0000000000000012
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: This article describes the methods and results of the early part (experimental pain tests and postoperative analgesia) of a study that assesses genetic and other factors related to acute pain and persistent pain after treatment of breast cancer in a prospective cohort of 1,000 women. Methods: One thousand consenting patients were recruited to the study. Before surgery (breast resection or mastectomy with axillary surgery), the patients filled in questionnaires about health, life style, depression (Beck Depression Inventory), and anxiety (State-Trait Anxiety Inventory). They were also exposed to experimental tests measuring heat (43 and 48 degrees C, 5 s) and cold (2-4 degrees C) pain intensity and tolerance. Anesthesia was standardized with propofol and remifentanil, and postoperative analgesia was optimized with i.v. oxycodone. Results: The patients showed significant interindividual variation in heat and cold pain sensitivity and cold pain tolerance. There was a strong correlation between the experimental pain measures across the tests. Presence of chronic pain, the number of previous operations, and particularly state anxiety were related to increased pain sensitivity. Previous smoking correlated with decreased heat pain sensitivity. These factors explained 4-5% of the total variance in pain sensitivity in these tests. Oxycodone consumption during 20 h was significantly higher in patients who had axillary clearance. Oxycodone consumption had only a weak correlation with the experimental pain measures. Conclusions: Contact heat and cold pressure tests identify variability in pain sensitivity which is modified by factors such as anxiety, chronic pain, previous surgery, and smoking. High levels of anxiety are connected to increased pain sensitivity in experimental and acute postoperative pain.
引用
收藏
页码:1410 / 1421
页数:12
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