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改善高能骨科创伤后的疼痛管理及长期预后(疼痛研究)

Improving Pain Management and Long-Term Outcomes Following High-Energy Orthopaedic Trauma (Pain Study).

作者信息

Castillo Renan C, Raja Srinivasa N, Frey Katherine P, Vallier Heather A, Tornetta Paul, Jaeblon Todd, Goff Brandon J, Gottschalk Allan, Scharfstein Daniel O, OʼToole Robert V

机构信息

*Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine; ‡Department of Orthopaedics, The MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH; §Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA; ‖Department of Orthopaedic Surgery, Louisiana State University Health Shreveport, Shreveport, LA; ¶Department of Pain Management, Brooke Army Medical Center, San Antonio, TX; **Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ††R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

出版信息

J Orthop Trauma. 2017 Apr;31 Suppl 1:S71-S77. doi: 10.1097/BOT.0000000000000793.

Abstract

Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures. The primary outcomes are chronic pain, opioid utilization during the 48 hours after definitive fixation and surgery for nonunion in the year after fixation. Secondary outcomes include preoperative and postoperative pain intensity, adverse events and complications, physical function, depression, and post-traumatic stress disorder. One year treatment costs are also compared between the groups.

摘要

骨科创伤后疼痛控制不佳是身体残疾和众多负面长期后果的一个预测指标。尽管人们越来越意识到疼痛控制不佳的负面后果,但骨科创伤后住院患者的镇痛治疗仍然不一致,而且往往不充分。疼痛研究是一项三臂、前瞻性、双盲、多中心随机试验,旨在评估标准疼痛管理与标准疼痛管理加围手术期非甾体抗炎药或普瑞巴林对18至85岁四肢骨折患者的效果。主要结局指标为慢性疼痛、确定性固定后48小时内的阿片类药物使用情况以及固定后一年内骨不连手术情况。次要结局指标包括术前和术后疼痛强度、不良事件和并发症、身体功能、抑郁以及创伤后应激障碍。还比较了两组之间的一年治疗费用。

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