Chiang Han-Liang, Huang Yu-Chi, Lin Huey-Shyan, Chan Min-Ho, Chia Yuan-Yi
Department of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
School of Medicine, National Defense Medicine Center, Taipei 114, Taiwan.
Pain Res Manag. 2019 Jan 9;2019:8946195. doi: 10.1155/2019/8946195. eCollection 2019.
The relationship between pain and hypertension is of great pathophysiological and clinical interest in the pain field, but the mechanism is poorly understood. This study used the postoperative patient-controlled analgesia (PCA) dose and the visual analysis scale (VAS) score to assess the relationship between pain and hypertension.
In this prospective study in a single-center hospital, 200 participants were enrolled and divided into three groups: normotensive group, hypertension without treatment group, and hypertension with treatment group. The participants scheduled for elective inhalational general anesthesia were interviewed at hospital admission.
A significant difference was observed in analgesic dosage on postoperative days 1, 2, and 3 between the female normotensive group and female hypertension with treatment group (=0.021, 0.014, 0.032). No significant differences in the VAS scores and PCA dosages were observed between the male normotensive group and any one of the male hypertensive groups.
We agree that hypertensive hypoanalgesia exists in some experimental settings. The mechanism linking postoperative pain and hypertension is far more complex than we initially believed. Therefore, more studies are required to investigate the roles that antihypertensive drugs, sex, and psychological stress play. Antihypertensive drugs may play a crucial role in mediating the relationship between pain and hypertension. Psychosocial factors were discussed but were not examined.
疼痛与高血压之间的关系在疼痛领域具有重要的病理生理学和临床意义，但相关机制尚不清楚。本研究采用术后患者自控镇痛（PCA）剂量和视觉模拟评分法（VAS）来评估疼痛与高血压之间的关系。
在一家单中心医院进行的这项前瞻性研究中，招募了200名参与者，并将其分为三组：血压正常组、未治疗高血压组和治疗高血压组。对计划接受择期吸入全身麻醉的参与者在入院时进行访谈。
女性血压正常组与女性治疗高血压组在术后第1、2和3天的镇痛剂量存在显著差异（=0.021、0.014、0.032）。男性血压正常组与任何一个男性高血压组之间在VAS评分和PCA剂量方面均未观察到显著差异。
我们认同在某些实验环境中存在高血压性痛觉减退。术后疼痛与高血压之间的联系机制比我们最初认为的要复杂得多。因此，需要更多研究来调查抗高血压药物、性别和心理压力所起的作用。抗高血压药物可能在介导疼痛与高血压之间的关系中起关键作用。文中讨论了社会心理因素，但未进行研究。
