Central Sensitisation and Postoperative Pain

N/AUnknownNCT04220697

Université Catholique de Louvain70 enrolled

Overview

One out of 10 patients undergoing surgery develops persistent post-surgical pain (PPSP). Unfortunately, available therapies for treating this pain have limited success. It is therefore of great importance to find strategies to prevent PPSP. The goal of this project is to find new screening tools that identify patients that are at risk for developing PPSP. Tissue injury and inflammation following surgery increase the excitability of spinal nociceptive neurons ("central sensitisation", CS) with pain hypersensitivity as consequence. It is thought that CS plays an important role in persistent pain. The first objective of this project is to assess in human patients if the propensity to develop CS manifested as secondary hyperalgesia before surgery is predictive for PPSP. In addition, we will test if the frequency content of the resting-state EEG reflecting the initial state of the brain will be related to the propensity for developing CS and to the presence of PPSP at two months after surgery.

Study Type

INTERVENTIONAL

Allocation

Purpose

SCREENING

Masking

NONE

Enrollment

Conditions

Thoracotomy Hyperalgesia Hyperalgesia, Secondary

Interventions

electroencephalography (EEG)OTHER

recording of resting state EEG using 64 surface electrodes

questionnairesOTHER

Hospital Anxiety Depression Scale (HADS) Neuropathic Pain questionnaire (DN4) Brief Pain Inventory (BPI) Fatigue Assessment Scale (FAS)

high frequency electrical stimulation of the forearm skin (HFS)OTHER

HFS consists of transcutaneous electrical stimuli delivered as 42 Hz trains (pulse width: 2 ms) lasting 1 s. The trains are repeated 12 times. Each train is separated by 10 seconds.

cutaneous mechanical pinprick stimulationOTHER

Mechanical pinprick stimuli will be applied manually by the operator on the skin using a mechanical stimulator (maximum weight 128 mN).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Scheduled for a lateral thoracotomy as treatment for primary lung cancer * Ability to provide written informed consent Exclusion Criteria: * Evidence for a clinically-significant alteration of the skin of the volar forearms * Pregnancy * Having a pacemaker or implanted cardiac defibrillator

Outcomes

Primary Outcomes

mechanical pinprick perceived intensity

magnitude of the increase in sensitivity to mechanical pinprick stimuli after HFS

Time frame: 1 day before surgery

area of increased mechanical pinprick sensitivity

spatial extent of the increased sensitivity to mechanical pinprick stimuli after HFS

Time frame: 1 day before surgery

resting state EEG

frequency content of the resting state EEG

Time frame: 1 week before surgery