title: Prolonged differential wound hyperalgesia after an interval of unilateral epidural blockade during lower abdominal surgery.
abstract: 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.
authors.affiliation: *Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland; and †Department of Anesthesiology, Greater Baltimore Medical Center, Towson, Maryland.
authors.forename: Allan
authors.initials: A
authors.lastname: Gottschalk
authors.forename: Steven M
authors.initials: SM
authors.lastname: Frank
mesh_terms: D000005:Abdomen / Q000601:surgery; D015360:Analgesia, Epidural; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000628:therapy*; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*