Brix Lone Dragnes, Thillemann Theis Muncholm, Bjørnholdt Karen Toftdahl, Nikolajsen Lone
Department of Anaesthesiology, Horsens Regional Hospital, Sundvej 30, 8700 Horsens, Denmark.
Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
SICOT J. 2019;5:21. doi: 10.1051/sicotj/2019021. Epub 2019 Jun 18.
The aims of this prospective study were to determine the prevalence of pain 6 months after arthroscopic subacromial decompression (ASD) and/or acromioclavicular joint resection (AC resection), to reveal causes of the pain, and to identify risk factors for persistent pain.
Preoperatively, patients were tested for their endogenous capacity to modulate pain and completed questionnaires concerning psychological vulnerability. Patients with pain 6 months after surgery were examined by an experienced orthopaedic surgeon to reveal any shoulder pathology responsible for the pain.
Data from 101 patients were available for analysis 6 months after surgery. Thirty-six patients had persistent pain: 32 underwent examination by the surgeon who identified shoulder pathology in ten patients, but not in the remaining 22 in whom ongoing insurance case, unemployment, and a general tendency to worry were risk factors for persistent pain.
The prevalence of persistent pain 6 months after ASD and/or AC resection was 35.6% (95% CI 26.1-45.8%) and the proportion of patients with shoulder pathology was 9.9%. An association between ongoing insurance case, unemployment, general tendency to worry (t-STAI), and unexplained persistent pain 6 months after surgery was found.
本前瞻性研究的目的是确定关节镜下肩峰下减压术(ASD)和/或肩锁关节切除术(AC切除术)6个月后疼痛的发生率,揭示疼痛原因,并确定持续性疼痛的危险因素。
术前,对患者进行内源性疼痛调节能力测试,并完成有关心理易损性的问卷调查。术后6个月有疼痛的患者由经验丰富的骨科医生进行检查,以发现任何导致疼痛的肩部病变。
术后6个月有101例患者的数据可供分析。36例患者存在持续性疼痛:32例接受了外科医生的检查,其中10例被发现有肩部病变,其余22例未发现病变,其中持续的保险理赔、失业以及普遍的担忧倾向是持续性疼痛的危险因素。
ASD和/或AC切除术后6个月持续性疼痛的发生率为35.6%(95%可信区间26.1-45.8%),有肩部病变的患者比例为9.9%。发现持续的保险理赔、失业、普遍的担忧倾向(t-STAI)与术后6个月无法解释的持续性疼痛之间存在关联。