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[骨科手术干预后的疼痛过程:以全膝关节置换术为例的特征描述]

[Course of pain after operative orthopedic interventions: Characterization exemplified by total knee arthroplasty].

作者信息

Benditz A, Völlner F, Baier C, Götz J, Grifka J, Keshmiri A

机构信息

Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Deutschland.

出版信息

Schmerz. 2016 Apr;30(2):181-6. doi: 10.1007/s00482-015-0072-7.

Abstract

BACKGROUND

The number of cases of orthopedic surgery is still increasing and postoperative pain management is of great importance for the patients. Therefore, in this study factors influencing the pain and the developement of pain in general in the first 7 days after total knee arthroplasty were examined.

MATERIAL AND METHODS

A total of 28 patients were included in this prospectively designed trial and underwent total knee arthroplasty with psoas compartment and sciatic nerve regional anesthesia and additionally propofol sedation. Postoperative pain scores were documented using a numerical rating scale (NRS) and anthropometric data and perioperative parameters were correlated with the postoperative pain score.

RESULTS

Evaluation of the pain values per interval showed that the maximum and the mean postoperative pain levels decreased up to day 4 after surgery and then increased. No significant effects of the analyzed parameters age, body mass index (BMI), duration of surgery and catheter indwelling time could be found. Female patients had significantly more pain than males in this collective.

CONCLUSION

The results show that there were no factors which have a significant influence on the degree of postoperative pain. Female patients suffered from more pain than males. There was an increase in pain after postoperative day 4 which might be the effect of more extensive mobilization and reduced effects of regional anesthesia. It is important that pain is treated in the early postoperative period.

摘要

背景

骨科手术病例数量仍在增加,术后疼痛管理对患者至关重要。因此,本研究对全膝关节置换术后前7天影响疼痛及疼痛总体发展的因素进行了检查。

材料与方法

本前瞻性设计试验共纳入28例患者,采用腰大肌间隙和坐骨神经区域麻醉并联合丙泊酚镇静进行全膝关节置换术。使用数字评分量表(NRS)记录术后疼痛评分,并将人体测量数据和围手术期参数与术后疼痛评分进行关联。

结果

对各时间段疼痛值的评估显示,术后疼痛的最大值和平均值在术后第4天前下降,然后上升。未发现所分析参数年龄、体重指数(BMI)、手术持续时间和导管留置时间有显著影响。在这个群体中,女性患者的疼痛明显多于男性。

结论

结果表明,没有因素对术后疼痛程度有显著影响。女性患者比男性患者疼痛更严重。术后第4天后疼痛增加,这可能是更广泛活动及区域麻醉效果降低的结果。术后早期进行疼痛治疗很重要。

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