Kompleks Bölgesel Ağrı Sendromu Olan ve Olmayan Hastalarda Cilt İletkenlik Monitörü Kullanılarak Sempatik Aktivitenin Karşılaştırılması

Abstract

Amaç: Sempatik sinir sistem disfonksiyonu, kompleks bölgesel ağrı sendromu patofizyolojisinde yer alan teoriler arasında tanımlanmıştır. Kompleks bölgesel ağrı sendromu olan hastalarda etkilenen ekstremitenin sempatik aktivitesinin objektif ölçümü, literatürde normal denekler ile karşılaştırılmamıştır. Cilt iletkenlik monitörü, invazif olmayan ve ekstremitenin cilt sempatik aktivitesini objektif olarak ölçebilen bir monitördür. Bu çalışmada, kompleks bölgesel ağrı sendromu olan ve olmayan deneklerde ekstremitelerin sempatik aktivitesindeki farklılıkların bir cilt iletkenlik monitörü kullanılarak karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Sempatik cilt yanıtları, alt ekstremite kompleks bölgesel ağrı sendromu tip 1 olan 13 hastada etkilenen ekstremitelerden alınan 25 ölçüm ve kontrol grubundaki 50 normal denekten alınan 50 ölçüm olmak üzere 63 denekte değerlendirildi. Cilt iletkenlik endeksleri arasında "saniyede tepe sayısı (0,02)" endeksi, ana sempatik cilt yanıt endeksi olarak kullanıldı. Tanımlayıcı kriterler ve sempatik cilt yanıt ölçümlerinin ortalama değerleri karşılaştırıldı. Bulgular: Cilt iletkenlik monitörü ile “saniyede tepe sayısı (0,02)” endeksi kullanılarak sempatik cilt yanıtları karşılaştırıldığında, kompleks bölgesel ağrı sendromu olan grup ile kompleks bölgesel ağrı sendromu tanısı olmayan kontrol grubu arasında ekstremitelerde sempatik aktivite açısından istatistiksel olarak anlamlı bir fark bulunmadı (p=0,837). Sonuç: Bu çalışmada, kompleks bölgesel ağrı sendromu olan hastaların etkilenen ekstremitelerindeki cilt sempatik sinir aktivitesi, kompleks bölgesel ağrı sendromu tanısı olmayan normal denekler ile benzerdi. Kompleks bölgesel ağrı sendromunda sempatik aktivitedeki değişiklikleri değerlendirmek için daha ileri çalışmalara ihtiyaç vardır.

Keywords

• kompleks bölgesel ağrı sendromu
• refleks sempatik distrofi
• Cilt iletkenliği
• sempatik sistem
• kozalji

Comparison of Sympathetic Activity by Use of Skin Conductance Monitor in Patients with and without Complex Regional Pain Syndrome

Abstract

Aim: Sympathetic system dysfunction has been described among the theories involved in the pathophysiology of complex regional pain syndrome. Objective measurement of the sympathetic activity of the affected extremity in patients with complex regional pain syndrome has not been compared to normal subjects in the literature. The skin conductance monitor is a non-invasive monitor that can objectively measure sympathetic skin activity of the extremity. In this study, we aimed to compare the differences in sympathetic activity of extremities in subjects with and without complex regional pain syndrome by using a skin conductance monitor. Material and Methods: Sympathetic skin responses were evaluated in 63 subjects, including 25 measurements on the affected extremities in 13 patients with lower extremity complex regional pain syndrome type 1 and 50 measurements in 50 normal subjects in the control group. Among the skin conductance indices, the "peaks per second (0.02)" index was used as the main sympathetic skin response index. Descriptive criteria and the mean values of sympathetic skin response measurements were compared. Results: When sympathetic skin responses were compared with a skin conductance monitor using the "peaks per second (0.02)" index, no statistically significant difference was found between the complex regional pain syndrome and control groups in terms of sympathetic activity in the extremities (p=0.837). Conclusion: In this study, skin sympathetic nerve activity in the affected limb of patients with complex regional pain syndrome was similar to normal subjects. Further studies are required to assess the changes in sympathetic activity in complex regional pain syndrome.

Keywords

• Complex regional pain syndrome
• Reflex sympathetic dystrophy
• skin conductance
• sympathetic system
• causalgia

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