Dietrich Eva-Maria, Griessinger Norbert, Neukam Friedrich Wilhelm, Schlittenbauer Tilo
Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany.
Department of Anesthesiology, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany.
J Craniomaxillofac Surg. 2017 Feb;45(2):281-289. doi: 10.1016/j.jcms.2016.12.009. Epub 2016 Dec 14.
Postoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment.
A total of 128 patients treated at our clinic in the period 2012-2015 who required analgesic treatment adaptation by our pain clinic were included. They were further divided into 10 groups: tumor, temporomandibular joint disorder, tooth extraction, osteomyelitis, bisphosphonate-related osteonecrosis of the jaw, submandibular abscess, orthognathic surgery, cyst, sinusitis, and fracture. Pain characteristics evaluated were intensity on a numerical rating scale (NRS) before and after intervention of the pain clinic, quality, genesis, and type.
Post treatment pain intensity values at rest 1.8 (SD: 1.4) and on exercise (walking and physical therapy) 4 (SD: 2) were statistically significant better compared to pretreatment values (4.2, SD: 2.5, and 6.8 SD: 2, respectively). The highest pain intensities were reported after tooth extractions, orthognathic surgery, cystectomies, and fracture reposition. Pain was mainly continuous and related to a combination of a somatic and a neuropathic pathophysiological mechanism.
Intervention by a specialized pain clinic leads to reduction of postoperative pain.
术后疼痛管理对于改善患者护理至关重要。我们的主要目标是研究疼痛门诊的镇痛治疗调整对口腔颌面外科术后疼痛缓解的影响。此外,我们旨在呈现患者的疼痛特征及所给予的镇痛治疗。
纳入了2012年至2015年期间在我们诊所接受治疗且需要我们疼痛门诊进行镇痛治疗调整的128例患者。他们进一步被分为10组:肿瘤、颞下颌关节紊乱、拔牙、骨髓炎、双膦酸盐相关颌骨坏死、下颌下脓肿、正颌手术、囊肿、鼻窦炎和骨折。评估的疼痛特征包括疼痛门诊干预前后的数字评分量表(NRS)强度、性质、成因和类型。
与治疗前的值(分别为4.2,标准差:2.5,以及6.8,标准差:2)相比,治疗后静息时的疼痛强度值为1.8(标准差:1.4),运动时(行走和物理治疗)为4(标准差:2),在统计学上有显著改善。拔牙、正颌手术、囊肿切除和骨折复位后报告的疼痛强度最高。疼痛主要为持续性,与躯体和神经病理性病理生理机制的组合有关。
专业疼痛门诊的干预可减轻术后疼痛。