British Leprosy Relief Association
Pain perception and functional limitation, assessed in the years after nerve decompression in leprosy
CabralElifaz De Freitasc
ReisFelipe José Jandre Dosd
aDivision of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
bPostgraduation Program in Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
cSanta Marcelina Hospital, Rondônia, Brazil
dFederal Institute of Rio de Janeiro, Rio de Janeiro, Brazil
eDivision of Neurosurgery, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
fDivision of Neurosurgery, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
Correspondence to: Maria Kátia Gomes, Pós Graduação em Cínica Médica - Departamento de Medicina de Família e Comunidade/Faculdade de Medicina – UFRJ Rua Laura de Araújo n° 36 - 2° andar Cidade Nova - Rio de Janeiro - RJ - Brazil - CEP: 20211-170 (Tel: +55 21 98841-2388; e-mail: firstname.lastname@example.org)
Surgical decompression of peripheral nerve trunks is a widely recognised procedure in the management of leprosy-associated neuropathy in endemic areas. The purpose of this study is to explore patients’ perception in terms of pain and functional limitation after neural decompression surgery in leprosy.
Fifty-three patients (87 surgeries) underwent peripheral nerve decompression surgery from 1999 to 2014 at our institution and were eligible for this study. Patients were interviewed with a semi-structured form and established questionnaires (DN-4, McGill Pain Questionnaire, visual analogue scale [VAS], and SALSA) and then physical impairments were assessed by physical examination. Some data were retrospectively retrieved from medical records for comparative analysis.
Surgery occurred with a mean time of 5.1 ± 4.1 years, prior to the interview. Most (59%) patients had one operated limb and 38 (71.7%) declared complete resolution of pain after surgery. There was a 64% reduction in the use of analgesics and an 81% reduction in corticosteroid use. Postoperative chronic pain affected 15 patients (28.3%), mostly of neuropathic type (86.7%). The majority of patients were generally satisfied (87%) with the surgical results and 58.5% of subjects had mild or no functional limitation at the time of the interview.
Patients had a positive experience after neural decompression surgery for leprosy-associated neuropathy in terms of reduced pain and functional limitation, and high levels of satisfaction.
leprosyneuropathyneural compressionpainsurgerypatient’s perception