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Volume 6, Issue 5 (Suppl) J Pain Relief, an open access journal
ISSN: 2167-0846 Pain Management 2017
October 05-06, 2017
Page 34
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Pain Research And Management
Bart Torensma, J Pain Relief 2017, 6:5(Suppl)
DOI: 10.4172/2167-0846-C1-013
Pain sensitivity and pain scoring in patients with severe obesity
Background: There are indications that pain perception is altered in patients with obesity, which complicates postoperative
pain treatment. An essential part for adequate pain treatment is the capacity of the patient to grade pain.
Aim: The aim of this study was to identify the differences in pain perception and pain processing in patients with and without
obesity.
Setting: The following task was set up at Dutch Obesity Clinic West; private practice and the Leiden University Medical Center,
the Netherlands; University Hospital.
Methods: 41 patients with severe obesity (body mass index 42.9 ± 4.9 kg/m2) and 35 control subjects (body mass index 23.2
± 2.8 kg/m2) received multiple random thermal and electrical stimuli to the skin, in intensity in-between pain threshold and
tolerance. The consistency of scoring was assessed by a penalty score system and stratified into cohorts good, moderate and
poor.
Results: The penalty scores differed significantly between patients with obesity and controls with higher penalty scores in
patients with obesity for both nociceptive assays. Combining the results of the heat and electrical tests showed that just 28% of
the patients with obesity had a penalty score in cohort good indicative of consistency in grading incoming stimuli, in contrast
to 60% of control subjects.
Conclusions: Individuals with severe obesity displayed hypoalgesia to noxious electrical stimuli together with difficulty in
grading experimental noxious thermal and electrical stimuli in between pain threshold and tolerance. We argue that the latter
may have a significant effect on pain treatment, and consequently needs to be taken into account when treating the patients
with obesity for acute or chronic pain.
Biography
Bart Torensma pursued MSc and has experience in Epidemiology and Anesthesiology. As CRNA he developed, in the last 10 years, the fast track bariatric surgery for the
Dutch Obesity Clinics in the Netherlands. As PhD candidate at the University of Leiden (LUMC) he is doing research in the subjects with obesity combining this with the
research in the operation theatre during surgery. Deep neuromuscular blockage and the finding of reducing pain post-operative with lower opiate consumption is one of
his research projects. Furthermore, he developed his own Masterclass in epidemiology, anesthesiology and physiological effects of stress in the brain and the effect on
the human behavior.
Bart Torensma
Leiden University Medical Center, Netherlands