Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery

Introduction:. Both positive (burning, stabbing, and allodynia) and negative (numbness) neuropathic symptoms may arise after surgery but likely contribute differently to patients' postoperative pain experience. Numbness has been identified as divergent from positive neuropathic symptoms and the...

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Autores principales:	K. Mikayla Flowers, Meghan Beck, Carin Colebaugh, Simon Haroutounian, Robert R. Edwards, Kristin L. Schreiber
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/f88c486ba1d84e188a5da042ee471c53
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spelling	oai:doaj.org-article:f88c486ba1d84e188a5da042ee471c532021-11-25T07:59:40ZPain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery2471-253110.1097/PR9.0000000000000976https://doaj.org/article/f88c486ba1d84e188a5da042ee471c532021-11-01T00:00:00Zhttp://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000000976https://doaj.org/toc/2471-2531Introduction:. Both positive (burning, stabbing, and allodynia) and negative (numbness) neuropathic symptoms may arise after surgery but likely contribute differently to patients' postoperative pain experience. Numbness has been identified as divergent from positive neuropathic symptoms and therefore excluded from some neuropathic assessment tools (Neuropathic Pain Scale for PostSurgical patients [NeuPPS]). Objectives:. In this prospective longitudinal study of patients undergoing breast surgery, we aimed to delineate the time course of numbness and its coincidence with NeuPPS and to contrast the association of surgical, psychosocial, and psychophysical predictors with the development of negative vs positive neuropathic symptoms. Methods:. Patients reported surgical area sensory disturbances at 2 weeks and 3, 6, and 12 months postoperatively. Association of baseline demographic, surgical, psychosocial, and psychophysical factors with NeuPPS and numbness across time was investigated using generalized estimating equation linear and logistic regression. Results:. Numbness was consistently reported by 65% of patients; positive neuropathic symptoms were less common, often decreasing over time. Neuropathic Pain scale for PostSurgical patients and numbness co-occurred in half of patients and were both associated with greater clinical pain severity and impact, younger age, axillary surgery, and psychosocial factors. More extensive surgery and chemotherapy were only associated with numbness. Conversely, other chronic pain, lower physical activity, perioperative opioid use, negative affect, and lower baseline pressure pain threshold and tolerance were only associated with NeuPPS. Patients reporting numbness alone did not endorse substantial clinical pain. Conclusions:. Differentiation of predictors, prevalence, and time course of numbness vs NeuPPS in breast surgical patients revealed important distinctions, suggesting that their independent assessment is worthwhile in future studies of postsurgical pain.K. Mikayla FlowersMeghan BeckCarin ColebaughSimon HaroutounianRobert R. EdwardsKristin L. SchreiberWolters KluwerarticleAnesthesiologyRD78.3-87.3ENPAIN Reports, Vol 6, Iss 4, p e976 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anesthesiology RD78.3-87.3
spellingShingle	Anesthesiology RD78.3-87.3 K. Mikayla Flowers Meghan Beck Carin Colebaugh Simon Haroutounian Robert R. Edwards Kristin L. Schreiber Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
description	Introduction:. Both positive (burning, stabbing, and allodynia) and negative (numbness) neuropathic symptoms may arise after surgery but likely contribute differently to patients' postoperative pain experience. Numbness has been identified as divergent from positive neuropathic symptoms and therefore excluded from some neuropathic assessment tools (Neuropathic Pain Scale for PostSurgical patients [NeuPPS]). Objectives:. In this prospective longitudinal study of patients undergoing breast surgery, we aimed to delineate the time course of numbness and its coincidence with NeuPPS and to contrast the association of surgical, psychosocial, and psychophysical predictors with the development of negative vs positive neuropathic symptoms. Methods:. Patients reported surgical area sensory disturbances at 2 weeks and 3, 6, and 12 months postoperatively. Association of baseline demographic, surgical, psychosocial, and psychophysical factors with NeuPPS and numbness across time was investigated using generalized estimating equation linear and logistic regression. Results:. Numbness was consistently reported by 65% of patients; positive neuropathic symptoms were less common, often decreasing over time. Neuropathic Pain scale for PostSurgical patients and numbness co-occurred in half of patients and were both associated with greater clinical pain severity and impact, younger age, axillary surgery, and psychosocial factors. More extensive surgery and chemotherapy were only associated with numbness. Conversely, other chronic pain, lower physical activity, perioperative opioid use, negative affect, and lower baseline pressure pain threshold and tolerance were only associated with NeuPPS. Patients reporting numbness alone did not endorse substantial clinical pain. Conclusions:. Differentiation of predictors, prevalence, and time course of numbness vs NeuPPS in breast surgical patients revealed important distinctions, suggesting that their independent assessment is worthwhile in future studies of postsurgical pain.
format	article
author	K. Mikayla Flowers Meghan Beck Carin Colebaugh Simon Haroutounian Robert R. Edwards Kristin L. Schreiber
author_facet	K. Mikayla Flowers Meghan Beck Carin Colebaugh Simon Haroutounian Robert R. Edwards Kristin L. Schreiber
author_sort	K. Mikayla Flowers
title	Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
title_short	Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
title_full	Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
title_fullStr	Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
title_full_unstemmed	Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
title_sort	pain, numbness, or both? distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/f88c486ba1d84e188a5da042ee471c53
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Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery

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