FEATURES OF PERIOPERATIVE PAIN IN PATIENTS WITH DEGENERATIVE LUMBAR SPINE DISORDERS
Keywords:
neuropathic pain, lumbar spine surgery, pressure algometryAbstract
Objective. Lumbar spine pain may be nociceptive or neuropathic in origin. Neuropathic component may need additional treatment in perioperative period and potentially may influence the result. Aim of the study was to determine the incidence of neuropathic pain in patients who were elected for lumbar spine surgery and its influence on postoperative period. Material and methods. Forty-two ASA I–II patients were enrolled to the study. They were investigated preoperatively and on the 3rd day of postoperative period. We used VAS for intensity of pain in movements and at rest, neuropathic pain diagnostic questionnaire (DN4) before surgery, pressure algometry before surgery and on the 3rd day after and opioid requirements during 24 hours. Results and discussion. We revealed that 52.4 % of patients had neuropathic pain before surgery and their general intensity of pain at movement was higher (7.7±1.5 vs 5.7±2.5, p<0.05). Women were more prone to neuropathic pain than men. Patients with neuropathic pain were less tolerant to pressure algometry preoperatively (2.7±1.5 vs 4.0±1.6, p<0.05) and postoperatively (3.0±1.7 vs 4.3±0.9 p<0.05). We found moderate correlation between algometry before and after surgery (r= 0.68), DN4 and pain at rest before surgery (r=0.48), algometry before operation and pain intensity at movements after operation (r=0.46). Conclusions. Incidence of neuropathic pain in patients elected for lumbar spine surgery is 52.4 %. In these patients, total pain level is higher. Pressure algometry may be a sensitive marker of neuropathic pain and predictor of postoperative pain intensity.
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