Mei Chih-Chun, Lee Fu-Ying, Yeh Hwey-Chin
Department of Periodontics, Section of Dentistry, LinKou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
J Clin Periodontol. 2016 Dec;43(12):1151-1159. doi: 10.1111/jcpe.12618. Epub 2016 Nov 2.
To evaluate patients' pain perception following periodontal or implant surgery and to explore risk factors associated with post-surgical pain.
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.
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.
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.
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。
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。
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。
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。