A clinically feasible method for the assessment and characterization of pain in patients with chronic pancreatitis

Pain is the primary symptom of chronic pancreatitis (CP), but methods for sensory testing and pain characterization have not previously been validated for clinical use. We present a clinically feasible method for the assessment and characterization of pain mechanisms in patients with CP based on qua...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2020-01, Vol.20 (1), p.25-34
Main Authors: Phillips, Anna Evans, Faghih, Mahya, Kuhlmann, Louise, Larsen, Isabelle M., Drewes, Asbjørn Mohr, Singh, Vikesh K., Yadav, Dhiraj, Olesen, Søren Schou
Format: Article
Language:English
Subjects:
Abdomen
Age
Algorithms
Analgesics
Central sensitization
Chronic pancreatitis
Enrollments
Family medical history
Lithotripsy
Methods
Narcotics
Nociception
Pain
Pancreas
Pancreatic diseases
Pancreatitis
Patients
Pressure
Questionnaires
Spinal cord
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Summary:Pain is the primary symptom of chronic pancreatitis (CP), but methods for sensory testing and pain characterization have not previously been validated for clinical use. We present a clinically feasible method for the assessment and characterization of pain mechanisms in patients with CP based on quantitative sensory testing (QST). This was a cross-sectional, multicenter study of 122 control subjects without pancreatic disease and another 60 patients with painful CP. All subjects underwent standardized QST assessments including a cold pressor test, a conditioned pain modulation paradigm, repetitive pin-prick stimuli (temporal summation) and pressure stimulation of the upper abdominal (pancreatic) and control dermatomes. The effects of age and gender on QST assessment parameters were investigated and normative reference values based on quartile regression were derived and implemented in algorithms to categorize patients according to their patterns of central pain processing (normal vs. segmental sensitization vs. widespread sensitization). Absolute pressure thresholds were subject to clinically relevant gender effects (all p 
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2019.11.007