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Sensory profiles in women with neuropathic pain after breast cancer surgery.

乳腺癌术后神经性疼痛女性的感觉特征。

  • 影响因子:3.45
  • DOI:10.1007/s10549-020-05681-8
  • 作者列表:"Mustonen L","Vollert J","Rice ASC","Kalso E","Harno H
  • 发表时间:2020-07-01
Abstract

PURPOSE:We performed a detailed analysis of sensory function in patients with chronic post-surgical neuropathic pain (NP) after breast cancer treatments by quantitative sensory testing (QST) with DFNS (German Research Network on Neuropathic Pain) protocol and bed side examination (BE). The nature of sensory changes in peripheral NP may reflect distinct pathophysiological backgrounds that can guide the treatment choices. NP with sensory gain (i.e., hyperesthesia, hyperalgesia, allodynia) has been shown to respond to Na+-channel blockers (e.g., oxcarbazepine). METHODS:104 patients with at least "probable" NP in the surgical area were included. All patients had been treated for breast cancer 4-9 years ago and the handling of the intercostobrachial nerve (ICBN) was verified by the surgeon. QST was conducted at the site of NP in the surgical or nearby area and the corresponding contralateral area. BE covered the upper body and sensory abnormalities were marked on body maps and digitalized for area calculation. The outcomes of BE and QST were compared to assess the value of QST in the sensory examination of this patient group. RESULTS:Loss of function in both small and large fibers was a prominent feature in QST in the area of post-surgical NP. QST profiles did not differ between spared and resected ICBN. In BE, hypoesthesia on multiple modalities was highly prevalent. The presence of sensory gain in BE was associated with more intense pain. CONCLUSIONS:Extensive sensory loss is characteristic for chronic post-surgical NP several years after treatment for breast cancer. These patients are unlikely to respond to Na+-channel blockers.

摘要

目的: 我们通过定量感觉测试 (QST) 对乳腺癌治疗后慢性手术后神经病理性疼痛 (NP) 患者的感觉功能进行了详细分析与 DFNS (德国神经病理性疼痛研究网络) 方案和床侧检查 (BE)。外周 NP 感觉改变的性质可能反映了不同的病理生理背景,可以指导治疗选择。具有感觉增益 (即感觉过敏、痛觉过敏、异常性疼痛) 的 NP 已被证明对 Na + 通道阻滞剂 (如奥卡西平) 有反应。 方法: 纳入 104 例手术区至少 “可能” NP 的患者。所有患者均在 4-9 年前接受过乳腺癌治疗,手术医生验证了肋间臂神经 (ICBN) 的处理情况。QST 在手术或附近区域及相应对侧区域的 NP 部位进行。在体图上标记被覆盖的上身和感觉异常,并进行面积计算的数字化。比较 BE 和 QST 的结局,评估 QST 在该患者组感觉检查中的价值。 结果: 小纤维和大纤维功能丧失是术后 NP 区 QST 的突出特征。备用和切除的 ICBN 之间的 QST 概况没有差异。在 BE 中,多种方式的感觉减退非常普遍。BE 中感觉增益的存在与更剧烈的疼痛相关。 结论: 广泛的感觉丧失是乳腺癌治疗几年后慢性手术后 NP 的特征。这些患者不太可能对 Na + 通道阻滞剂有反应。

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影响因子:2.87
发表时间:2020-01-31
来源期刊:Bioscience reports
DOI:10.1042/BSR20192546
作者列表:["Chen X","Theobard R","Zhang J","Dai X"]

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