Central sensitization: Neurons are awake; are we?

Abstract

Central sensitization (CS) is a known entity associated with prolonged intense painful stimulation secondary
to neuropathic or inflammatory peripheral disease and manifests as a heightened responsiveness of the
patient to even mild peripheral input. Although numerous protocols are available for its treatment, there
have been no reports about the patient’s behavior under anesthesia while operating for related or nonrelated
surgery and management thereof. These patients might require high doses of anesthetic agents to
achieve the required depth of anesthesia for surgery. We present three reports of patients who required
high doses of anesthetic agents for optimum operative conditions. Two of these were managed with
ketamine.