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脊柱手术患者术前和术后的生活满意度和疼痛干扰:阿片类药物使用患者与阿片类药物初治患者的比较。

Life satisfaction and pain interference in spine surgery patients before and after surgery: comparison between on-opioid and opioid-naïve patients.

机构信息

Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Kuopio, Finland.

Department of Anaesthesia and Operative Services, Kuopio University Hospital, PO Box 100, 70029, Kuopio, Finland.

出版信息

Qual Life Res. 2018 Nov;27(11):3013-3020. doi: 10.1007/s11136-018-1961-x. Epub 2018 Aug 2.

Abstract

PURPOSE

Pain has a negative impact on life satisfaction (LS). Our primary aims were to compare LS in on-opioid and opioid-naïve spine surgery patients and to evaluate whether surgery affects LS during the first 3 weeks after surgery.

METHODS

After informed consent 200 patients (99 on-opioid, 101 opioid-naïve; 112 male; aged 23-71 years) having elective spine surgery were enrolled. Their LS was evaluated using a four-item Life Satisfaction Scale (4-20, lower score more satisfied) and pain interference using Brief Pain Inventory (BPI)-questionnaire (0-10, lower score, less interference) before and 21 days after surgery.

RESULTS

At baseline LS was lower in the ON-OPIOID-group, mean LS-score 10.6 (SD 3.9), than that in the OPIOID-NAÏVE-group, 9.3 (3.0) (p = .027). At 3 weeks after surgery LS had increased in both groups compared to baseline (p < .001). However, LS was still lower in the ON-OPIOID-group, 9.1 (3.7) than that in the OPIOID-NAÏVE-group, 7.6 (2.7) (p = .005). Patients with lower LS experienced more pain interference pre- and post-operatively (p < .001). At 3 weeks the pain interference had decreased in both groups, in the ON-OPIOID-group from mean BPI-score 5.1 (2.0) to 3.0 (2.0) (p < .001) and in the OPIOID-NAÏVE-group from 4.0 (2.1) to 2.4 (2.3) (p < .001), but BPI-score was still higher in the ON-OPIOID-group (p = .045).

CONCLUSION

Life satisfaction increased and pain interference decreased in both groups after spine surgery. However, LS was lower and pain interference was more significant in on-opioid patients than that in opioid-naïve patients.

摘要

目的

疼痛对生活满意度(LS)有负面影响。我们的主要目的是比较接受非阿片类药物和阿片类药物的脊柱手术患者的 LS,并评估手术是否会在术后 3 周内影响 LS。

方法

在获得知情同意后,共纳入 200 名接受择期脊柱手术的患者(99 名非阿片类药物,101 名阿片类药物初治;112 名男性;年龄 23-71 岁)。在手术前和手术后 21 天,使用四项生活满意度量表(4-20,分数越低越满意)和简明疼痛量表问卷(BPI)(0-10,分数越低,干扰越小)评估他们的 LS 和疼痛干扰。

结果

在基线时,ON-OPIOID 组的 LS 较低,平均 LS 评分为 10.6(SD 3.9),低于 OPIOID-NAÏVE 组的 9.3(3.0)(p=0.027)。在术后 3 周时,两组与基线相比 LS 均有所增加(p<0.001)。然而,ON-OPIOID 组的 LS 仍较低,为 9.1(3.7),低于 OPIOID-NAÏVE 组的 7.6(2.7)(p=0.005)。LS 较低的患者术前和术后疼痛干扰更严重(p<0.001)。在术后 3 周时,两组的疼痛干扰均有所减轻,ON-OPIOID 组从平均 BPI 评分为 5.1(2.0)降至 3.0(2.0)(p<0.001),OPIOID-NAÏVE 组从 4.0(2.1)降至 2.4(2.3)(p<0.001),但 ON-OPIOID 组的 BPI 评分仍较高(p=0.045)。

结论

脊柱手术后两组的 LS 增加,疼痛干扰减少。然而,ON-OPIOID 组的 LS 较低,疼痛干扰更明显,高于阿片类药物初治组。

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