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术前疼痛灾难化预测全膝关节置换术后疼痛结局。

Preoperative pain catastrophizing affects pain outcome after total knee arthroplasty.

机构信息

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan.

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan.

出版信息

J Orthop Sci. 2022 Sep;27(5):1096-1099. doi: 10.1016/j.jos.2021.05.011. Epub 2021 Jul 3.

Abstract

BACKGROUNDS

Preoperative widespread pain sensitization or pain catastrophizing could be associated with chronic pain after total knee arthroplasty (TKA). The aim of the present study was to examine the association between postoperative pain in patients undergoing TKA and preoperative factors, including patient characteristics and preoperative central sensitization as well as pain catastrophizing.

METHODS

Preoperative TKA patients were evaluated using the Central Sensitization Inventory (CSI)-9 and Pain Catastrophizing Scale (PCS). Postoperative knee pain was evaluated using a numerical rating scale (NRS) 6 months after TKA. Statistical analyses were performed to assess the relationship between NRS 6 months after TKA and preoperative factors, including patient characteristics, CSI-9, and PCS.

RESULTS

We enrolled 58 consecutive patients with osteoarthritis who underwent TKA. Using cutoff of 14, postoperative NRS was higher in the patients with ≥14 than the patients with <14 in CSI (p = 0.025). Postoperative NRS was higher in the patients with ≥30 than the patients with <30 in PCS (p = 0.043). Preoperative PCS was a significant risk factor of postoperative pain using a multivariate analysis.

CONCLUSIONS

Surgeon should recognize preoperative PCS could affect postoperative pain 6 months after TKA.

摘要

背景

术前广泛疼痛敏化或疼痛灾难化可能与全膝关节置换术后(TKA)的慢性疼痛有关。本研究的目的是探讨 TKA 术后患者的术后疼痛与术前因素之间的关系,包括患者特征和术前中枢敏化以及疼痛灾难化。

方法

使用中枢敏化量表(CSI)-9 和疼痛灾难化量表(PCS)对术前 TKA 患者进行评估。TKA 后 6 个月,采用数字评分量表(NRS)评估膝关节疼痛。进行统计分析以评估 TKA 后 6 个月 NRS 与术前因素(包括患者特征、CSI-9 和 PCS)之间的关系。

结果

我们纳入了 58 例接受 TKA 的骨关节炎连续患者。使用 14 的截止值,CSI 中≥14 的患者术后 NRS 高于<14 的患者(p=0.025)。PCS 中≥30 的患者术后 NRS 高于<30 的患者(p=0.043)。多因素分析显示,术前 PCS 是术后疼痛的一个显著危险因素。

结论

外科医生应认识到术前 PCS 可能会影响 TKA 后 6 个月的术后疼痛。

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