Department of Anaesthesiology, University Hospital of Tampere, Finland.
Eur J Anaesthesiol. 2010 May;27(5):455-60. doi: 10.1097/EJA.0b013e328335b31c.
The prevalence of persistent pain after orthopaedic surgery has been the subject of only few studies and the risk factors for persistent pain have been evaluated even more rarely. The purpose of the present study was to evaluate the degree and the risk factors of persistent pain after knee arthroplasty.
The prevalence of persistent postoperative pain after knee replacement was evaluated with a questionnaire in a large, register-based cross-sectional prevalence study. The main hypothesis was that the type of operation (primary, bilateral, revision) would influence the prevalence of persistent postoperative pain. Logistic regression analysis was performed to test the hypothesis and to find other possible risk factors for the development of persistent pain.
The total number of patients was 855. The operation was a primary arthroplasty in 648 patients (75.7%), a bilateral arthroplasty in 137 patients (21.1%) and a revision arthroplasty in 70 patients (8.2%). The response rate was 65.7%. The type of operation was not associated with the prevalence of persistent pain, but the degree of early postoperative pain was the strongest risk factor. If the degree of pain during the first postoperative week was from moderate to intolerable, the risk for the development of persistent pain was three to 10 times higher compared with patients complaining of mild pain during the same period. Other risk factors were the long duration of preoperative pain and female sex.
Intensity of early postoperative pain and delayed surgery increase the risk of the persistent pain after knee arthroplasty.
骨科手术后持续性疼痛的发生率仅在少数研究中有所涉及，而持续性疼痛的风险因素则评估得更少。本研究旨在评估膝关节置换术后持续性疼痛的程度和风险因素。
我们在一项大型基于注册的横断面患病率研究中，通过问卷调查评估膝关节置换术后持续性术后疼痛的发生率。主要假设是手术类型（初次、双侧、翻修）会影响持续性术后疼痛的发生率。我们进行逻辑回归分析来检验该假设，并寻找可能导致持续性疼痛发展的其他潜在风险因素。
总共有 855 名患者。648 名患者（75.7%）接受了初次关节置换术，137 名患者（21.1%）接受了双侧关节置换术，70 名患者（8.2%）接受了翻修关节置换术。应答率为 65.7%。手术类型与持续性疼痛的发生率无关，但术后早期疼痛程度是最强的风险因素。如果术后第一周的疼痛程度为中度至无法忍受，与同一时期轻度疼痛的患者相比，发展为持续性疼痛的风险增加 3 至 10 倍。其他风险因素包括术前疼痛持续时间长和女性性别。
术后早期疼痛强度和手术延迟会增加膝关节置换术后持续性疼痛的风险。
