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初次全髋关节和膝关节置换术后急性术后疼痛和焦虑的预测因素。

Predictors of acute postsurgical pain and anxiety following primary total hip and knee arthroplasty.

机构信息

Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.

出版信息

J Pain. 2013 May;14(5):502-15. doi: 10.1016/j.jpain.2012.12.020. Epub 2013 Mar 27.

Abstract

UNLABELLED

This study aims to examine the joint role of demographic, clinical, and psychological variables as predictors of acute postsurgical pain and anxiety in patients undergoing total knee arthroplasty and total hip arthroplasty. A consecutive sample of 124 patients was assessed 24 hours before (T1) and 48 hours after (T2) surgery. Demographic, clinical, and psychological factors were assessed at T1 and several postsurgical pain issues, anxiety, and analgesic consumption were evaluated at T2. Hierarchical linear regression analyses were performed to identify predictors of acute pain and anxiety following surgery. In the final multivariate model, presurgical optimism emerged as the main significant predictor of postsurgical pain intensity. Presurgical optimism also had a significant role in the prediction of postsurgical anxiety, together with presurgical anxiety level and emotional representation of the condition leading to surgery (osteoarthritis). A significant positive correlation between postsurgical anxiety and acute pain was also confirmed. The present study enhances our understanding of predictors of acute pain and anxiety following total knee arthroplasty and total hip arthroplasty by showing the relevance of psychological factors, over and above other potential clinical predictors. These findings could be used to develop targeted interventions aimed at acute postsurgical pain and anxiety management following major joint arthroplasties.

PERSPECTIVE

This article reveals the significant influence of psychological factors on the prediction of acute pain and anxiety 48 hours after primary total hip and knee arthroplasty. These results could prove useful for the design of interventions aimed at postsurgical pain and anxiety management.

摘要

本研究旨在探讨人口统计学、临床和心理变量作为全膝关节置换术和全髋关节置换术患者急性术后疼痛和焦虑的预测因子的共同作用。连续样本 124 例患者在手术前 24 小时(T1)和术后 48 小时(T2)进行评估。在 T1 时评估人口统计学、临床和心理因素,并在 T2 时评估术后疼痛、焦虑和镇痛药物的使用情况。采用分层线性回归分析确定术后急性疼痛和焦虑的预测因子。在最终的多元模型中,术前乐观是术后疼痛强度的主要显著预测因子。术前乐观与术前焦虑水平以及导致手术(骨关节炎)的疾病的情绪表达一起,对术后焦虑的预测也有重要作用。术后焦虑与急性疼痛之间也存在显著的正相关。本研究通过显示心理因素的相关性,进一步了解了全膝关节置换术和全髋关节置换术后急性疼痛和焦虑的预测因子,超过了其他潜在的临床预测因子。这些发现可用于设计针对主要关节置换术后急性术后疼痛和焦虑管理的靶向干预措施。

观点

本文揭示了心理因素对初次全髋关节和膝关节置换术后 48 小时急性疼痛和焦虑的预测的显著影响。这些结果对于设计术后疼痛和焦虑管理干预措施可能非常有用。

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