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If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Cardiovascular:
R. P. Alston and P. Pechon
Dysaesthesia associated with sternotomy for heart surgery
Br. J. Anaesth. 2005; 95: 153-158 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Pain memory can be a factor for dysaesthesia in CABG patients
Verda Toprak, Verda Toprak, E Alp Yenyur, Gonul Tezcan Keles   (2 August 2005)

Pain memory can be a factor for dysaesthesia in CABG patients 2 August 2005
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Verda Toprak,
M.D.
Celal Bayar University,
Verda Toprak, E Alp Yenyur, Gonul Tezcan Keles

Send letter to journal:
Re: Pain memory can be a factor for dysaesthesia in CABG patients

Dear Editor, We read with great interest the paper by Alston R.P. and Pechon P. about dysaesthesia associated with sternotomy for heart surgery. In their study, they implicated dysaesthesia was strongly correlated with CABG surgery but not with valve surgery(1). This result led us to make a comment on pain memory. Acute pain memory research has suggested an association between emotional state and pain memories(2). Memory for pain is an important research and clinical issue since patients abiility to accurately recall pain plays a prominent role in medical practice (3). The pain memory caused by previous attacks of angina of CABG patients can lead to dysaesthesia following CABG operation. The previous memories of pain of CABG patients might have effected their perception of postoperative pain and this could be the reason for the discrepancies between valve surgery and CABG patients. Besides authors have tested the dysaesthesiaonly after 48 hours of surgery. If the theory of the study is dysaesthesia can cause chronic pain, then the patients could be tested at third and sith months following surgery. There is still much to be learnt about the complex interactions between pain perception and complex surgical interventions.

V. Toprak EA. Yentur G. Tezcan Keles Manisa, Turkey

References: 1. Alston R.P.and Pechon P. Dysaesthesia associated with sternotomy for heart surgery. Br J Anaesth 2005;95:153-8 2. Gedney YY, Logan H. Memory for stress associated with acute pain. The Journal of Pain 2004;5:83-91 3. Everts B, Karlson B, Wahrborg P, Abdon N, Herlitz J, Hedner T. Pain recollection after chest pain of cardiac origin. Cardiology.1999;92:115- 20.

Conflict of Interest:

None declared