Presence of a neuropathic pain component in patients with chronic pain after gunshot wounds

Abstract

In patients with gunshot wounds, chronic pain is observed in 70% of cases. One of the factors that influence such a high frequency of pain chronicity is the number of localizations of injured anatomical parts of the body – in patients with injuries in 1 or 2 anatomical parts of the body, the frequency of chronicity is 69.7%, and in patients with injuries in 3 – 71.2% of cases. Also, the presence of a neuropathic component of pain in this category of patients and its possible impact on such a high frequency of chronicity remains unexplored.
 Materials. The treatment of 769 patients was analyzed. The Douleur Neuropathique 4 questions were used to identify neuropathic pain. The Shapiro-Wilk, Mann-Whitney, Friedman's Bonferroni correction, and chi-square test with a continuity correction were also used. In all cases, the critical level of significance was set at 0.05.
 Results. Douleur Neuropathique 4 questions data indicate that all patients had a neuropathic pain component (scores range from 4 to 5). At the time of discharge at the stage of treatment in military medical clinical centers, we observed the absence of a neuropathic component of pain in some patients – these were those patients who did not have chronic pain. After 1 month – p=0.918, 3 months – 0.713, 6 months – p=0.824, and 12 months – p=0.911 observation, the data did not differentiate.
 Conclusions. Patients who received gunshot wounds have a high risk of chronic pain. It was found that the neuropathic component of pain is present in all patients of this category, so it may be one of the key components of such a high frequency of chronicity.