The Associated Factors and Clinical Features of Neuropathic Pain After Brachial Plexus Injuries: A Cross-sectional Study.

Abstract

Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients. The clinical features of neuropathic pain, including pain intensity, type and time phase, need to be investigated. Moreover, possible associated factors need to be explored. A cross-sectional study containing 77 participants was conducted. Their baseline information and injury-related conditions were collected. The Present Pain Index evaluated by the Visual Analog Scale, self-reports using the specific pain questionnaires were used for screening and estimating the patients' pain. T test, χ test, Logistic Regression, and correlation coefficient were used when conducting the statistical analyses. The occurrence rate of neuropathic pain in our study was 54.5%. Paresthesia/dysesthesia had the highest average score in our population. Among potential associated factors, smoking (P=0.001), regular alcohol drinking (P=0.001), total brachial plexus injuries (P=0.01), and avulsions (P=0.019) were related to the development of neuropathic pain. Patients with neuropathic pain experienced significantly poorer function of the upper limbs measured by the Disabilities of Arm, Hand and Shoulder questionnaire (P<0.01). There was a significant positive correlation between the function of the upper limbs and pain intensity (r=0.60, P<0.001). Though the pain type and time phase manifested differently across patients, paresthesia/dysesthesia occurred most commonly. Patients were more likely to develop neuropathic pain if they had total brachial plexus injuries, avulsion and bad life habits. Moreover, the function of the upper limbs was affected by pain.