Neuropathic component of pain in patients with mine blast wounds

Abstract

In patients with mine blast wounds, chronic pain is observed in an average of 83.3 % of cases, and it has been found that this is influenced by the number of anatomical body parts injured. For patients who sustained injuries in 1 or 2 anatomical body parts, the frequency of pain chronicity is 82.2 %, while in individuals who suffered injuries in ≥ 3 anatomical body parts, it is 91.7%. Objective — to investigate the presence of a neuropathic component of pain in patients with mine blast wounds and its impact on the frequency of pain chronicity. Materials and methods. The results of the treatment of 280 patients who suffered blast injuries during combat operations were analyzed. Since the number of anatomically affected body regions affects pain chronicization, patients were allocated into two groups: Group 1 included 169 patients with injuries in 1 or 2 anatomical body regions, and Group 2 included 111 patients with injuries in more than 2 anatomical regions. The Douleur Neuropathique 4 questions questionnaire was used to diagnose neuropathic pain. Results. Data from the Douleur Neuropathique 4 questions diagnostic questionnaire indicate that all patients had a neuropathic component of pain (4—6 points). There was no statistically significant difference at all stages of treatment: in military mobile hospitals (p = 0.911), in military medical clinical centers (p = 0.771), at the time of discharge from inpatient treatment (p = 0.931), one month after discharge (p = 0.949), three months after discharge (p = 0.931), six months after discharge (p = 0.927), and twelve months after discharge (p = 0.842). Conclusions. Patients who received mine blast wounds have a high frequency of chronic pain. The risk of chronicity is influenced by the neuropathic component of pain, which was present in all patients in this category, as indicated by the data from the Douleur Neuropathique 4 questions diagnostic questionnaire.