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Anesth Analg 2007; 105:1784-1786
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000270206.30333.cb
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ANALGESIA

The Use of Brain Positron Emission Tomography to Identify Sites of Postoperative Pain Processing With and Without Epidural Analgesia

Asokumar Buvanendran, MD*, Amjad Ali, MD{dagger}, Travis R. Stoub, PhD{ddagger}, Richard A. Berger, MD§, and Jeffrey S. Kroin, PhD*

From the Departments of *Anesthesiology, {dagger}Radiology, {ddagger}Neurology, and §Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois.

Address correspondence and reprint requests to Asokumar Buvanendran, MD, Department of Anesthesiology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612. Address e-mail to Asokumar{at}aol.com.

Abstract

It is not known how different analgesic regimes affect the brain when reducing postoperative pain. We performed positron emission tomography (PET) scans on a 69-yr-old woman in the presence of moderate postoperative pain and then with epidural analgesia producing complete analgesia, during the first 2 days after total knee arthroplasty. Day 2 postsurgery PET scan data (no pain with epidural analgesia) were subtracted from Day 1 postsurgery PET scan data (time of moderate pain without epidural analgesia) to determine the brain regions activated. Postsurgical pain was associated with increased activity in the contralateral primary somatosensory cortex. Other brain regions showing increased postsurgical activity were the contralateral parietal cortex, bilateral pulvinar and ipsilateral medial dorsal nucleus of the thalamus, contralateral putamen, contralateral superior temporal gyrus, ipsilateral fusiform gyrus, ipsilateral posterior lobe, and contralateral anterior cerebellar lobe. This study demonstrates the feasibility of evaluating the central processing of acute postoperative pain using PET.




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Anesth. Analg., December 1, 2007; 105(6): 1526 - 1527.
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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 © 2007 by the International Anesthesia Research Society.