Pain flashbacks in posttraumatic stress disorder.
OBJECTIVE
Surgical patients who regain consciousness while under general anesthesia may develop symptoms of Posttraumatic Stress Disorder (PTSD). One common PTSD symptom is the experiencing of abnormal perceptions during which the patient feels as if the trauma is recurring. The objective of this report is to document the re-occurrence of pain as part of the PTSD sequelae.


RESULTS
We present two patients who developed PTSD following an episode of awareness under anesthesia. In both cases, posttraumatic sequelae persisted for years and included pain symptoms that resembled, in quality and location, pain experienced during surgery. In addition to their similarity to the original pain, these pain symptoms were triggered by stimuli associated with the traumatic situation, suggesting that they were flashbacks to the episode of awareness under anesthesia.


CONCLUSIONS
The similarity between the patients' pain symptoms and pain experienced during trauma, the triggering by traumatic cues, and the associated emotional arousal and avoidance suggest the involvement of a somatosensory memory mechanism.
Salomons
Timothy V
TV
Department of Anesthesia and Pain Management, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada.
Osterman
Janet E
JE
Gagliese
Lucia
L
Katz
Joel
J
D000328:Adult; D000368:Aged; D001364:Awareness; D001416:Back Pain / Q000523:psychology; D002908:Chronic Disease; D004325:Dreams / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007796:Laminectomy / Q000009:adverse effects; D010535:Laparoscopy; D008568:Memory; D010146:Pain / Q000523:psychology*; D013246:Sterilization, Tubal; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*