Persistent sensory dysfunction in pain‐free herniotomy

Abstract

Persistent sensory dysfunction is common in pain-free post-herniotomy patients. Future studies of sensory function in persistent post-herniotomy pain should compare the findings to the present data in order to characterize individual patients and potentially identify subgroups, which may aid in allocation of patients to pharmacological or surgical treatment.

Neurophysiological Characterization of Persistent Postthoracotomy Pain

“…Albeit no significant differences between PTPS and pain-free patients for TDT were observed, our findings of an increased TDT on the operated side, in both groups, are consistent with results from persistent pain not only after inguinal hernia repair 13,23,24 and mastectomy 14 but also after thoracotomy, 12 although the PTPS group in the latter study consisted of only 3 pain patients. Assessment of deep tissue sensitivity with pressure algometry (PPT and PPTo) has demonstrated decreased thresholds on the operated side compared with the control side in patients with persistent postoperative pain.…”

“…However, the findings in this study of increased thresholds to thermal stimuli (WDT, CDT, HPT) in PTPS patients compared with pain-free patients, corroborate data from recent studies in inguinal persisting postherniotomy pain. 13,23 Although the possibility of a type I error in our data cannot be excluded, the highly significant increase in WDT in PTPS patients suggests a more profound impact on C-fibers than in pain-free patients.…”

Test-retest Agreement and Reliability of Quantitative Sensory Testing 1 Year After Breast Cancer Surgery

“…However, loss of sensory function has been reported in both pain and pain-free patients in the postsurgical patient population. 7,17,18 The reliability analysis of pain scores is comparable to other studies of reliability of "current pain" scores. 32 The reliability of pain scores is lower than QST, suggesting that pain is a more dynamic condition than sensory dysfunction.…”

“…Thus, it is clinically useful and allows comparing measurement error with clinically relevant changes. 14 Despite the fact that QSTs have been used extensively in persistent postsurgical pain patients such as those undergoing hernia surgery, [15][16][17] thoracic surgery, 7,8,18 and breast cancer surgery, [2][3][4][5] further characterization of the reliability of QST in the postsurgical population is needed to fully account for the variation from the test itself, when interpreting the results. Therefore the aim of the present study was to evaluate the test-retest reliability of mechanical and thermal thresholds and sensory mapping in a well-characterized population of breast cancer patients 12 months after surgery.…”

International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

“…This differs from nociceptic pain, which is due to tissue injury or an inflammatory reaction [2]. However, recent studies in postherniotomy patients without pain have also demonstrated the significant occurrence of sensory disturbances compared to the un-operated side [4], indicating that, during both open and laparoscopic groin hernia repair, most patients develop some type of nerve lesion with secondary sensory disturbances, but that only a proportion (probably around 10%) will lead to a chronic pain [32]. Although preoperative pain may be related to the risk of developing chronic pain, there are no signs of preoperative sensory dysfunction in patients with or without pain [3].…”