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—Dr Day has brought up the problem of deafferentation-type pain, which is not frequently seen by surgeons after an operative procedure but is certainly seen rather commonly in pain centers. This type of pain is only relieved by sympathetic block, as Dr Day suggests. It frequently can be diagnosed by the fact that it is often a constant pain and is frequently made worse by light touch or by clothing that rubs on the incision. It is not the type of pain that is associated with deep palpation or that occurs after coughing or sneezing.I should have added, in my brief review of this problem, that when local measures are not effective it is wise for the surgeon to refer the patient to an anesthesiologist who is interested in pain relief problems or to a pain center.
Hermann RE. Persistent Postoperative Incisional Pain-Reply. JAMA. 1988;259(24):3559. doi:10.1001/jama.1988.03720240021020