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Characteristics and Associated Features of Persistent Post-Sympathectomy Pain

 

作者: Anastasios Kapetanos,   Andrea Furlan,   Angela Mailis-Gagnon,  

 

期刊: The Clinical Journal of Pain  (OVID Available online 2003)
卷期: Volume 19, issue 3  

页码: 192-199

 

ISSN:0749-8047

 

年代: 2003

 

出版商: OVID

 

关键词: surgical sympathectomy;neuropathic pain;sympathetically maintained pain;compensatory hyperhidrosis;gustatory sweating

 

数据来源: OVID

 

摘要:

ObjectivesThe aim of this study is to describe the incidence and characteristics of pain, sensory abnormalities, abnormal body sweating, and pathologic gustatory sweating in pain patients with persistent post-sympathectomy pain.MethodsA retrospective chart review of a series of consecutive pain patients with persistent post-sympathectomy pain was performed. Inclusion criteria were: (1) sympathectomy performed for the indication of neuropathic pain, and (2) persistent pain after the procedure. Demographic data, patterns of pain before and after sympathectomy, patients' pain drawings, and incidence of pain had been collected concurrently at the time of referral. Additional data regarding sensory findings, surgical details of the sympathectomy, sweat patterns, and incidence of abnormal body sweating and pathologic gustatory sweating were extracted from the patients' charts or obtained in follow-up appointments.ResultsSeventeen adults (13 females and 4 males) with a mean age of 37 years (range 25–52) at the time of sympathectomy met the inclusion criteria. Five of the 17 patients experienced temporary pain relief for an average of 4 months (range 2–12 months), 3/17 retained the same pain as before the surgery, 1 patient was cured of her original pain but experienced a new debilitating pain, and 8/17 patients continued to have the same or worse pain in addition to a new or expanded pain. Pathologic gustatory sweating was present in 7/11 patients asked, and abnormal sweating (known as compensatory hyperhidrosis) in 11/13 patients asked.DiscussionThe present study does not allow for conclusions about the effectiveness of surgical sympathectomy for neuropathic pain. However, our findings indicate that if the pain persists after the procedure, the complications may be quite serious and at times worse than the problem for which the surgery was originally performed.

 

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