Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Noerrebrogade 44, Building 1A, Aarhus 8000, Denmark Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark
Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
Br J Anaesth. 2016 May;116(5):655-61. doi: 10.1093/bja/aew069.
Substantial literature documents that persistent postsurgical pain is a possible outcome of many common surgical procedures. As fracture-related surgery implies a risk of developing neuropathic pain and complex regional pain syndrome (CRPS), further studies investigating the prevalence and pain characteristics are required.
All patients undergoing primary surgery because of ankle or wrist fracture at Hvidovre and Odense University Hospitals, Denmark, between April 15, 2013 and April 15, 2014, were identified from the Danish Fracture Database. A questionnaire regarding pain characteristics was sent to patients 1 yr after primary surgery.
Replies were received from 328 patients, of whom 18.9% experienced persistent postsurgical pain defined as pain daily or constantly at a level that interfered much or very much with daily activities, 42.8% reported symptoms suggestive of neuropathic pain, and 4.0% fulfilled the diagnostic patient-reported research criteria for CRPS.
Persistent postsurgical pain 1 yr after wrist and ankle fracture surgery is frequent, and a large proportion of patients experience symptoms suggestive of neuropathic pain and CRPS. Patients should be informed about the substantial risk of developing persistent postsurgical pain. Future studies investigating risk factors for persistent postsurgical pain that include both surgically and conservatively treated fractures are required.
大量文献证明,许多常见的手术都可能导致持续的术后疼痛。由于骨折相关手术存在发展为神经病理性疼痛和复杂性区域疼痛综合征(CRPS)的风险,因此需要进一步研究以调查其患病率和疼痛特征。
2013 年 4 月 15 日至 2014 年 4 月 15 日期间,丹麦 Hvidovre 和 Odense 大学医院对所有因踝关节或腕关节骨折而接受初次手术的患者进行了识别,来自丹麦骨折数据库。在初次手术后 1 年,向患者发送了一份关于疼痛特征的问卷。
共收到 328 名患者的回复,其中 18.9%的患者经历了持续性术后疼痛,定义为每天或持续存在的疼痛,其程度严重或非常严重地干扰日常活动;42.8%的患者报告有神经病理性疼痛的症状;4.0%的患者符合 CRPS 的诊断性患者报告研究标准。
腕关节和踝关节骨折手术后 1 年仍存在持续性术后疼痛的情况较为常见,很大一部分患者存在神经病理性疼痛和 CRPS 的症状。应告知患者存在发生持续性术后疼痛的重大风险。需要进一步研究包括手术和保守治疗骨折在内的影响持续性术后疼痛的风险因素。