Document Detail

Wound sensitivity as a measure of analgesic effects following surgery in human neonates and infants.
MedLine Citation:
PMID:  12237196     Owner:  NLM     Status:  MEDLINE    
Postoperative wound sensitivity following abdominal surgery in neonates and infants has been little investigated, and is not well understood. Our aim was to quantify this sensitivity using the abdominal skin reflex (ASR), and to test the hypothesis that the threshold of this reflex would decrease following surgery, and would increase with the administration of analgesia. We measured ASR thresholds in infants under 1 year receiving unilateral abdominal surgery and in a small comparison group of non-surgical infants. The reflex was elicited by applying calibrated von Frey hairs to both sides of the abdomen at the same segmental level. In addition to threshold, the degree of reflex radiation as denoted by hip flexion was measured. The reflex threshold was significantly lowered at the wound site by up to 78% following surgery, and subsequently increased to varying degrees based on the type of analgesia used. The post-surgical drop in threshold was accompanied by an increase in reflex radiation. Thresholds remained below pre-operative values 24 h after surgery on the operated side. In addition, it was observed that infants in whom the indication for surgery was a chronic condition, displayed lower threshold values on the affected side prior to surgery. An objective and quantitative measure has been developed of wound sensitivity and level of analgesia in infants following surgery. The reflex threshold also provides a means of quantifying human central sensory processing, and may be used to detect referred visceral hypersensitivity in this age group.
Katharine Andrews; Maria Fitzgerald
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pain     Volume:  99     ISSN:  0304-3959     ISO Abbreviation:  Pain     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-18     Completed Date:  2002-12-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  185-95     Citation Subset:  IM    
Copyright Information:
Copyright 2002 International Association for the Study of Pain
Department of Anatomy & Developmental Biology, Children Nationwide Paediatric Pain Research Centre, Gower Street, London WC1E 6BT, UK.
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MeSH Terms
Abdomen / innervation,  surgery*
Hernia / surgery
Hip Joint / physiology
Infant, Newborn
Neurons, Afferent / physiology
Pain Threshold / physiology
Pain, Postoperative / diagnosis*,  physiopathology*
Physical Stimulation
Reflex / physiology*
Skin / innervation

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