Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.
BT - Leprosy review IS - 3 J2 - Lepr Rev LA - eng N2 -Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.
PY - 2018 SP - 208 EP - 218 T2 - Leprosy review TI - Pain perception and functional limitation, assessed in the years after nerve decompression in leprosy UR - https://leprosyreview.org/article/89/3/20-8218 VL - 89 ER -