Song Jae-Yen, Chae Minsuk, Lee Hyunjoon, Moon Young-Eun
Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
J Clin Med. 2022 Jul 24;11(15):4295. doi: 10.3390/jcm11154295.
We hypothesized that preoperative lower back pain (LBP) may be associated with the severity of postoperative pain after gynecologic laparoscopy. This prospective observational study aimed to investigate the association between preoperative LBP and postoperative pain. We assessed the intensity of LBP before surgery and the postoperative pain after surgery. The abilities of preoperative LBP intensity, age, body mass index, and anesthetic duration time to predict moderate-to-severe postoperative pain were measured using receiver operating characteristic analysis. The data of 148 patients were analyzed. Only preoperative LBP intensity showed a significant association with moderate-to-severe postoperative pain (area under the curve, 0.71; 95% confidence interval, 0.63−0.79; p < 0.001). Preoperative LBP rated three on a numeric rating scale (NRS) had the highest combined sensitivity (75.3%) and specificity (58.3%). Patients with LBP above NRS 3 had more severe postoperative pain than those who did not (pain score 5.3 ± 2.2 vs. 3.9 ± 1.9, p < 0.001), leading to more opioid requirement in the recovery room (48.5% vs. 27.5%, p = 0.014). Preoperative LBP intensity is a useful factor for identifying patients at risk for pain after gynecologic laparoscopy.
我们假设术前下背部疼痛（LBP）可能与妇科腹腔镜检查术后疼痛的严重程度相关。这项前瞻性观察性研究旨在调查术前LBP与术后疼痛之间的关联。我们评估了手术前LBP的强度以及手术后的术后疼痛。使用受试者工作特征分析来测量术前LBP强度、年龄、体重指数和麻醉持续时间预测中度至重度术后疼痛的能力。对148例患者的数据进行了分析。只有术前LBP强度与中度至重度术后疼痛显示出显著关联（曲线下面积，0.71；95%置信区间，0.63−0.79；p<0.001）。在数字评分量表（NRS）上评分为3的术前LBP具有最高的综合敏感性（75.3%）和特异性（58.3%）。NRS高于3的LBP患者术后疼痛比无LBP患者更严重（疼痛评分5.3±2.2 vs. 3.9±1.9，p<0.001），导致恢复室中更多的阿片类药物需求（48.5% vs. 27.5%，p = 0.014）。术前LBP强度是识别妇科腹腔镜检查术后疼痛风险患者的一个有用因素。
