Postmastektomi meme kanserli hastalarda persistan ağrı ile taktil duyusal ve ağrı basıncı eşikleri arasındaki ilişki: Bir ön rapor

Öz

Amaç: Persistan postmastektomi ağrısı meme kanseri hastaları arasında yaygındır. Persistan postmastektomi ağrısının duyusal kayıp ve artan ağrı duyarlılığı ile ilişkisi belirsizliğini korumaktadır. Bu çalışmada postmastektomi meme kanseri hastalarında persistan postmastektomi ağrısı ile taktil duyusal eşikler ve ağrı basıncı eşikleri arasındaki ilişkiyi araştırdık. Materyal ve Metod: Hastalar persistan postmastektomi ağrısı varlığına ve yokluğuna göre iki gruba ayrıldı. Hem ameliyat edilen hem de ameliyat edilmeyen taraflarda ağrı basıncı eşikleri (meme, kol ve önkol) bir algometre cihazı ve taktil duyusal eşikler (skar bölgesi, meme üst dış kadran, aksiller bölge, median kutanöz sinir ve interkostobrakiyal sinir bölgeleri, önkol ve el) Semmes – Weinstein monofilaman testi kullanılarak ölçüldü. Bulgular: Hastaların 31'inde (% 64.6) persistan postmastektomi ağrısı saptandı. Ameliyatlı ve ameliyatsız tarafların dokunsal duyusal eşikleri ve ağrı basıncı eşikleri arasında istatistiksel olarak anlamlı bir fark vardı (P <0.001). Grupların ağrı basıncı eşikleri ile dokunsal duyusal eşikleri arasında istatistiksel olarak anlamlı bir fark yoktu. Ortalama ağrı şiddeti ile aksilller bölgeden ölçülen taktil duyusal eşiklerde taraf farkı arasında zayıf düzeyde pozitif korelasyon saptandı (P = 0.046, r = 0.289). Sonuç: Aksiller bölge duyusal kayıp ve persistan postmastektomi ağrısı, postmastektomi kanser hastalarında ilişkili olabilir. Ağrı duyarlılığı ve duyu kaybı ise persistan postmastektomi ağrısı ile ilişkili görünmemektedir.

Anahtar Kelimeler

• Persistan postmastektomi ağrı sendromu
• Taktil duyusal eşik
• Ağrı basınç eşiği
• Ağrı duyarlılığı
• Duyusal kayıp

The relationship between persistent pain and tactile sensory and pain pressure thresholds in postmastectomy breast cancer patients: A preliminary report

Öz

Background: Persistent postmastectomy pain is common among breast cancer patients. The relationship of persistent postmastectomy pain (PPP) with sensory loss and increased pain sensitization remains unclear. In this study, we investigated the relationship between PPP and tactile sensory thresholds and pain pressure thresholds in postmastectomy breast cancer patients. Methods: Patients were divided into two groups according to the presence and absence of PPP. On both the operated and non-operated sides, pain pressure thresholds (breast, arm, and forearm) were assessed using an algometer, and tactile sensory thresholds (scar region, breast upper outer quadrant, axillary region, median cutaneous nerve and intercostobrachial nerve regions, forearm, and hand) were measured using the Semmes–Weinstein monofilament test. Results: PPP was detected in 31 (64.6%) of the patients. There was a statistically significant difference in the tactile sensory thresholds and pain pressure thresholds of the operated and non-operated sides (P < 0.001). There was no statistically significant difference between the pain pressure thresholds and tactile sensory thresholds of the groups with and without PPP. There was a weak positive correlation between the mean pain intensity and side to side difference in tactile sensory thresholds measured from the axillary region (P = 0.046, r = 0.289). Conclusions: Axillary region sensorial loss and PPP may be linked in postmastectomy cancer patients. Pain sensitization and loss of sensation do not seem to be associated with PPP.

Anahtar Kelimeler

• Persistent postmastectomy pain syndrome
• Tactile sensory threshold
• Pain pressure threshold
• Pain sensitization
• Sensorial deficit

Kaynakça

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