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Anesth Analg 2005;100:1411-1413
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000150608.78242.1A

PAIN MEDICINE

Prolonged Differential Wound Hyperalgesia After an Interval of Unilateral Epidural Blockade During Lower Abdominal Surgery

Allan Gottschalk, MD, PhD*, and Steven M. Frank, MD{dagger}

*Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland; and {dagger}Department of Anesthesiology, Greater Baltimore Medical Center, Towson, Maryland

Address correspondence and reprint requests to Allan Gottschalk, MD, PhD, Department of Anesthesiology and Critical Care Medicine, Meyer 8-134, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287-4965. Address e-mail to agottschalk{at}jhmi.edu.

We assessed postoperative pain at rest and with movement along with wound hyperalgesia in a patient who had undergone lower abdominal surgery under general anesthesia with a unilateral epidural block that persisted throughout surgery and in whom the epidural catheter was replaced immediately afterward. Pain and wound hyperalgesia were consistently greater on the "unblocked" side for the 3-wk period of observation. Thus, even imperfect intraoperative attenuation of noxious stimuli can lead to persistent reductions in postoperative pain.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.