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The Associated Factors and Clinical Features of Neuropathic Pain After Brachial Plexus Injuries: A Cross-sectional Study

Zhou, Yingjie MD*,†,‡; Liu, Peixi MD§; Rui, Jing MD, PhD*,†,‡; Zhao, Xin MD, PhD*,†,‡; Lao, Jie MD, PhD*,†,‡

doi: 10.1097/AJP.0000000000000493
Original Articles

Introduction: Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients.

Objectives: The clinical features of neuropathic pain, including pain intensity, type and time phase, need to be investigated. Moreover, possible associated factors need to be explored.

Methods: A cross-sectional study containing 77 participants was conducted. Their baseline information and injury-related conditions were collected. The Present Pain Index evaluated by the Visual Analog Scale, self-reports using the specific pain questionnaires were used for screening and estimating the patients’ pain. T test, χ2 test, Logistic Regression, and correlation coefficient were used when conducting the statistical analyses.

Results: The occurrence rate of neuropathic pain in our study was 54.5%. Paresthesia/dysesthesia had the highest average score in our population. Among potential associated factors, smoking (P=0.001), regular alcohol drinking (P=0.001), total brachial plexus injuries (P=0.01), and avulsions (P=0.019) were related to the development of neuropathic pain. Patients with neuropathic pain experienced significantly poorer function of the upper limbs measured by the Disabilities of Arm, Hand and Shoulder questionnaire (P<0.01). There was a significant positive correlation between the function of the upper limbs and pain intensity (r=0.60, P<0.001).

Discussion: Though the pain type and time phase manifested differently across patients, paresthesia/dysesthesia occurred most commonly. Patients were more likely to develop neuropathic pain if they had total brachial plexus injuries, avulsion and bad life habits. Moreover, the function of the upper limbs was affected by pain.

*Department of Hand Surgery

§Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai

Key Laboratory of Hand Reconstruction, Ministry of Health

Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China

Y.Z. and P.L. contributed equally and share the first authorship.

Y.Z.: first author, conception and design of study, interview with the participants, collection and assembly of data, data analysis and interpretation, manuscript writing, and final approval of the manuscript. P.L.: collection and assembly of data, data analysis and interpretation, manuscript writing, and manuscript revision. He contributed equally with Y.Z. during this work and shares first authorship. J.R.: critical revision of the manuscript for important intellectual content. X.Z.: design of study, critical revision of the manuscript for important intellectual content. J.L.: corresponding author, conception and design of study, and final approval of manuscript.

Supported by the Ministry of Science and Technology of China, Beijing (973 Program Grant 2014CB542204 to Yun Wang). The authors declare no conflict of interest.

Reprints: Jie Lao, PhD, MD, Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China (e-mail: laojie633@sina.com).

Received December 5, 2016

Received in revised form February 6, 2017

Accepted February 12, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.