Pinto Patrícia R, Vieira Artur, Pereira Diamantino, Almeida Armando
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Life and Health Sciences Research Institute (ICVS)/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Life and Health Sciences Research Institute (ICVS)/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Anesthesiology Department, Braga Hospital, Braga, Portugal.
J Pain. 2017 Aug;18(8):947-955. doi: 10.1016/j.jpain.2017.03.003. Epub 2017 Mar 23.
Acute postsurgical pain (APSP) is a common and anticipated problem after surgery with detrimental consequences if not appropriately managed. This study examined the independent and joint contribution of presurgical demographic, clinical, and psychological variables as predictors of APSP intensity, evaluated using an 11-point numeric rating scale, after inguinal hernioplasty, one of the most performed surgeries worldwide. In a prospective observational cohort study, a consecutive sample of 135 men undergoing hernioplasty was assessed before and 48 hours after surgery. When adjusted for depression, helplessness, and magnification scores, a multiple hierarchical regression analysis revealed that younger age (β = -.247, P < .005), previous chronic pain (β = .175, P < .05), presurgical anxiety (β = .235, P < .05), and the rumination component of pain catastrophizing (β = .222, P < .05) were significant predictors of APSP intensity. The integrative predictive model found in this study revealed the simultaneous influence that demographic, clinical, and psychological factors have on APSP after inguinal hernioplasty. Therefore, these results improve knowledge on APSP predictors after inguinal hernioplasty and highlight potential modifiable intervention targets, such as anxiety and pain catastrophizing (rumination), for the design of interventions focused on APSP prevention and management. Hence, taken together, these findings lend support for the inclusion of presurgical screening and psychological interventions among surgical patients at risk for higher APSP intensity.
This study found that, when adjusted for depression, helplessness, and magnification scores, the variables younger age, previous chronic pain, presurgical anxiety, and the rumination component of pain catastrophizing are significant predictors of APSP intensity after inguinal hernioplasty. These findings improve knowledge on APSP and highlight potential modifiable intervention targets for the design of interventions focused on APSP prevention and management.
急性术后疼痛(APSP)是手术后常见且可预见的问题,若管理不当会产生有害后果。本研究考察了术前人口统计学、临床和心理变量作为APSP强度预测因素的独立及共同作用,APSP强度通过11点数字评定量表进行评估,该研究针对腹股沟疝修补术展开,这是全球开展最为广泛的手术之一。在一项前瞻性观察队列研究中,对135例行疝修补术的男性患者在手术前及术后48小时进行了连续抽样评估。在对抑郁、无助和放大分数进行校正后,多元层次回归分析显示,年龄较小(β = -0.247,P < 0.005)、既往慢性疼痛(β = 0.175,P < 0.05)、术前焦虑(β = 0.235,P < 0.05)以及疼痛灾难化的沉思成分(β = 0.