• M Granot and I Weissman-Fogel.
• Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
• Eur J Pain. 2012 Feb 1;16(2):247-55.

BackgroundSurgery-induced neuroplasticity at spinal and supra-spinal levels is assumed to evoke a clinical acute post-operative pain (cAPOP) experience, which is expressed by allodynia and/or hyperalgesia. It remains unclear whether the systemic pain perception measured outside the incision area remains unchanged and whether it is affected by the presence of cAPOP.AimsThis study explored whether the systemic perception of experimental pain would be altered towards hypersensitivity following elective gynecological surgery unmasked by opioids.MethodsA perioperative psychophysical evaluation of heat pain thresholds (HPT) and pain estimations were obtained in a remote bodily area before and after surgery among 35 women.ResultsThe ratings for both pain dimensions of intensity and unpleasantness remained stable following surgery. However, there was a reduction found in HPT the day after surgery (43.6 ± 2.2 °C to 42.2 ± 3.1 °C, p = 0.002). This reduction was associated with lower HPT measured before surgery (r = .56, p < 0.000) and with higher cAPOP intensity obtained at rest (r = -.44, p = 0.008).ConclusionsThis post-surgical allodynia, as reflected by the systemic enhancement of pain perception, may represent plasticity in the central pain pathways at the supra-spinal level. Pre-surgical assessment of a patient's pain perception profile may predict certain pain dimensions of post-surgical pain plasticity. The evaluation of individual pain profiles may contribute to a mechanism-based approach aimed to attenuate the cAPOP.© 2011 European Federation of International Association for the Study of Pain Chapters.

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