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牙周手术和种植手术后疼痛感知的评估。

Assessment of pain perception following periodontal and implant surgeries.

作者信息

Mei Chih-Chun, Lee Fu-Ying, Yeh Hwey-Chin

机构信息

Department of Periodontics, Section of Dentistry, LinKou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

出版信息

J Clin Periodontol. 2016 Dec;43(12):1151-1159. doi: 10.1111/jcpe.12618. Epub 2016 Nov 2.

Abstract

OBJECTIVE

To evaluate patients' pain perception following periodontal or implant surgery and to explore risk factors associated with post-surgical pain.

MATERIALS AND METHODS

Patients undergoing periodontal or implant surgery were recruited. Post-surgical pain perception was evaluated by a numeric rating scale (NRS, 1-10) after 1 week. Self-reported durations of pain (DOP) and of swelling (DOS), and consumption of prescriptions were also recorded. Demographic and surgical variables were compared between the groups of mild (MP) and moderate-to-severe post-surgical pain (SP). Factors associated with SP were analysed statistically.

RESULTS

Ten surgical types in three categories, comprising 330 surgeries in 253 patients, were included. Overall, 70.3% of the subjects experienced MP, 25.5% experienced moderate pain and 4.2% experienced severe pain. The highest median NRS score was found in subjects having advanced implant surgery [4.0, interquartile range (IQR) 4.00] and the lowest in open flap debridement surgery (1.0, IQR 1.00). The median DOP was 2.0 days (IQR 2.00). Analgesic need (median = 2.0 days, IQR 4.00) was correlated with the DOP (r = 0.406, p < 0.01) and the NRS score (r = 0.358, p < 0.01). Subjects receiving periodontal plastic surgery (OR = 3.20, 95% CI = 1.06-9.71), complex surgery (OR = 2.63, 95% CI = 1.31-5.25), increased surgical extension (OR = 1.78, 95% CI = 1.21-2.62) and increased anaesthesia (OR = 2.32, 95% CI = 1.13-4.76) were more likely to experience SP.

CONCLUSIONS

The majority of patients perceived mild post-surgical pain, but the pain level varied among different surgical procedures. Periodontal plastic surgery, complex surgery, surgical extension and anaesthetic volume were associated with more pain.

摘要

目的

评估牙周或种植手术后患者的疼痛感知,并探讨与术后疼痛相关的危险因素。

材料与方法

招募接受牙周或种植手术的患者。术后1周通过数字评分量表(NRS,1 - 10)评估术后疼痛感知。记录自我报告的疼痛持续时间(DOP)、肿胀持续时间(DOS)以及处方药物的使用情况。比较轻度(MP)和中度至重度术后疼痛(SP)组之间的人口统计学和手术变量。对与SP相关的因素进行统计学分析。

结果

纳入了三类共10种手术类型,包括253例患者的330例手术。总体而言,70.3%的受试者经历轻度疼痛,25.5%经历中度疼痛,4.2%经历重度疼痛。在进行晚期种植手术的受试者中,NRS评分中位数最高[4.0,四分位数间距(IQR)4.00],在开放瓣清创手术中最低(1.0,IQR 1.00)。DOP中位数为2.0天(IQR 2.00)。镇痛需求(中位数 = 2.0天,IQR 4.00)与DOP(r = 0.406,p < 0.01)和NRS评分(r = 0.358,p < 0.01)相关。接受牙周整形手术(OR = 3.20,95% CI = 1.06 - 9.71)、复杂手术(OR = 2.63,95% CI = 1.31 - 5.25)、手术范围增加(OR = 1.78,95% CI = 1.21 - 2.62)以及麻醉量增加(OR = 2.32,95% CI = 1.13 - 4.76)的受试者更有可能经历SP。

结论

大多数患者术后疼痛轻微,但不同手术程序的疼痛程度有所不同。牙周整形手术、复杂手术、手术范围和麻醉量与更多疼痛相关。

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