Benditz A, Maderbacher G, Zeman Florian, Grifka Joachim, Weber Markus, von Kunow Frederik, Greimel Felix, Keshmiri Armin
Department of Orthopaedics, University Medical Centre Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Centre for Clinical Studies, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
Arch Orthop Trauma Surg. 2017 Oct;137(10):1343-1348. doi: 10.1007/s00402-017-2769-9. Epub 2017 Aug 3.
The number of total hip and knee arthroplasties (THA and TKA) is steadily increasing. Many factors that influence pain have been reported, but little is known about the correlation between the time of day and the duration of surgery and postoperative pain. On one hand, surgical interventions are performed faster due to economic pressure; on the other hand, obtaining sound surgical skills and a thorough education are most important for young surgeons, particularly at university hospitals. Amidst these different interests, it is the patient who should be the focus of all medical efforts. Therefore, our study investigated the effects of the time of day and the duration of total knee and hip arthroplasty on postoperative pain perception and patient satisfaction.
623 patients were analyzed 24 h after primary total knee or hip arthroplasty regarding pain, patient satisfaction, and side effects by means of the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Management (QUIPS).
The time of day and the duration of knee or hip arthroplasty were not correlated with maximum, minimum, and activity-related pain and patient satisfaction rated on a numeric rating scale (NRS).
This study is the first to show that neither the time of day nor the duration of surgery has any influence on patient satisfaction and postoperative pain 24 h after total knee or hip arthroplasty; regarding these aspects, young orthopaedic surgeons may be trained in the operating theatre without time pressure.
全髋关节置换术（THA）和全膝关节置换术（TKA）的手术数量在稳步增加。虽然已经报道了许多影响疼痛的因素，但关于一天中的时间与手术持续时间和术后疼痛之间的相关性却知之甚少。一方面，由于经济压力，手术干预的速度更快；另一方面，对于年轻外科医生，尤其是在大学医院工作的年轻外科医生而言，掌握扎实的手术技能和接受全面的培训至关重要。在这些不同的关注点中，患者应该是所有医疗工作的核心。因此，我们的研究调查了一天中的时间以及全膝关节和髋关节置换术的持续时间对术后疼痛感知和患者满意度的影响。
通过德国范围内的术后疼痛管理质量改进项目（QUIPS）问卷，对623例接受初次全膝关节或髋关节置换术的患者在术后24小时进行疼痛、患者满意度和副作用方面的分析。
一天中的时间以及膝关节或髋关节置换术的持续时间与数字评分量表（NRS）评定的最大、最小及与活动相关的疼痛和患者满意度均无相关性。
本研究首次表明一天中的时间和手术持续时间对全膝关节或髋关节置换术后24小时的患者满意度和术后疼痛均无影响；在这些方面，年轻骨科医生可以在没有时间压力的情况下在手术室接受培训。
