Aouad Marie T, Kanazi Ghassan E, Malek Krystel, Tamim Hani, Zahreddine Lama, Kaddoum Roland N
Department of Anesthesiology, American University of Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon.
Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.
J Anesth. 2016 Feb;30(1):72-9. doi: 10.1007/s00540-015-2090-0. Epub 2015 Oct 24.
A prospective observational study is conducted to identify independent predictors of pain and morphine consumption following abdominal hysterectomy.
Preoperative State Trait Anxiety Inventory (STAI), Numerical Rating Scales (NRS) for anxiety and pain expectations, thermal pain thresholds and pain scores at forearm and incision site, and pain scores generated from the insertion of an intravenous catheter were measured in female patients undergoing abdominal hysterectomy. Pearson correlations between the predictors and the two outcome measures postoperative pain scores and morphine consumption were studied and multiple regression analysis was conducted to identify independent predictors (primary outcome). Secondary outcomes included cut-off values of predictive tools for morphine consumption.
Data from 60 patients were analyzed. STAI state anxiety, NRS pain expectations, and NRS anxiety scores were identified as independent predictors of postoperative morphine consumption. We identified a cut-off value of 4.5 (sensitivity 90 %, specificity of 60 %) for the NRS anxiety and a cut-off of 42.5 (sensitivity 70 %, specificity 70 %) for the state anxiety STAI score for increased postoperative morphine consumption.
Preoperative STAI state anxiety scores and NRS pain expectations are independent predictors for increased morphine consumption following hysterectomy. The STAI state anxiety tool and NRS 0-10 anxiety tool can be used interchangeably. The NRS 0-10 anxiety is a much simpler tool than STAI state anxiety and is associated with a higher sensitivity for high morphine consumption. Thermal pain thresholds and IV pain scores were not predictive of postoperative morphine consumption.
开展一项前瞻性观察性研究，以确定腹式子宫切除术后疼痛和吗啡消耗量的独立预测因素。
对接受腹式子宫切除术的女性患者测量术前状态特质焦虑量表（STAI）、焦虑和疼痛预期的数字评定量表（NRS）、前臂和切口部位的热痛阈值及疼痛评分，以及静脉置管时产生的疼痛评分。研究预测因素与两个结局指标（术后疼痛评分和吗啡消耗量）之间的Pearson相关性，并进行多元回归分析以确定独立预测因素（主要结局）。次要结局包括吗啡消耗量预测工具的临界值。
分析了60例患者的数据。STAI状态焦虑、NRS疼痛预期和NRS焦虑评分被确定为术后吗啡消耗量的独立预测因素。我们确定NRS焦虑的临界值为4.5（敏感性90%，特异性60%），状态焦虑STAI评分的临界值为42.5（敏感性70%，特异性70%），用于预测术后吗啡消耗量增加。
术前STAI状态焦虑评分和NRS疼痛预期是子宫切除术后吗啡消耗量增加的独立预测因素。STAI状态焦虑工具和NRS 0-10焦虑工具可互换使用。NRS 0-10焦虑是一种比STAI状态焦虑简单得多的工具，且与高吗啡消耗量的较高敏感性相关。热痛阈值和静脉疼痛评分不能预测术后吗啡消耗量。
