Has Central Sensitization Become Independent of Nociceptive Input in Chronic Pancreatitis Patients Who Fail Thoracoscopic Splanchnicectomy
Regional Anesthesia and Pain Medicine, 10/31/2011
Bouwense SAW et al. – Reduced supraspinal–but not spinal–central sensitization after bilateral thoracoscopic splanchnicectomy (BTS) was associated with significantly reduced pain scores in a majority of chronic pancreatitis patients (CPP). A subgroup showed no reductions in supraspinal central sensitization after BTS, coupled to no significant pain numeric rating scale (NRS) reduction. The results suggest that a subgroup of CPP has altered pain processing that may be independent of ongoing peripheral nociceptive input, resulting in persisting pain despite BTS. If confirmed, these results indicate the importance of sensory testing for indications and management of pain treatments.