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横断面电子调查肥胖症手术患者术前和术后慢性疼痛的发生率。

Cross-sectional E-survey on the Incidence of Pre- and Postoperative Chronic Pain in Bariatric Surgery.

机构信息

Department of Anaesthesiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

Medical Research Institute, Alexandria University, Alexandria, Egypt.

出版信息

Obes Surg. 2023 Jan;33(1):204-210. doi: 10.1007/s11695-022-06354-9. Epub 2022 Nov 8.

Abstract

BACKGROUND

To assess the prevalence, incidence, location, and behavior of chronic pre- and postoperative pain in bariatric surgery, and the use of analgesics.

METHODS

A cross-sectional e-survey was conducted on 3928 post-bariatric patients and four-time points for pain assessment were evaluated: preoperative, on the ward, day 1 at home postoperatively, and present time (at the time of the e-survey). A numerical rating scale (NRS) was used to assess the level of pain (0 to 10). The general incidence of chronic pain was calculated, as also, subgroups were defined as group A (pre and postoperative chronic pain), B (preoperative pain, and no longer postoperative), and C (preoperative painless, postoperative chronic pain). Besides the pain intensity, location of pain, and the use of analgesics were investigated.

RESULTS

A total of 3279 patients (83.9%) responded to the survey. Preoperative and postoperative chronic pain was found in 343 (10.5%) and 264 (8.1%) patients, respectively. In group A, chronic pain was present in 4.8% of the patients; in group B, it was present in 5.7%; and in group C in 3.3% of the patients. Furthermore, in 4.5% of patients pain was located in the abdomen, which was higher as compared to before surgery (+ 2.3%, p < 0.001). The ORs for present postoperative chronic pain were OR 1.45, 1.7, and 1.71 (p = 0.002, 0.003, 0.003) compared to respectively preoperative chronic pain, pain at the ward, and pain at day 1 after surgery. Among all participants, 4.6% consumed chronic analgesics. Of these, paracetamol was used most frequently (3.8%), followed by tramadol (1.3%) and oxycodone (0.5%).

CONCLUSIONS

In this e-survey, chronic postoperative abdominal pain was prominent in patients after bariatric surgery. Of patients, 3.3% that were without preoperative chronic pain developed chronic pain after surgery. Opioid consumption in the queried population was relatively low.

摘要

背景

评估减重手术后慢性术前和术后疼痛的患病率、发病率、部位和行为,以及镇痛药的使用情况。

方法

对 3928 名减重手术后患者进行了横断面电子调查,并评估了 4 个时间点的疼痛评估:术前、病房、术后第 1 天在家中和当前时间(在电子调查时)。使用数字评分量表(NRS)评估疼痛程度(0 到 10)。计算慢性疼痛的总体发生率,并定义亚组为 A 组(术前和术后慢性疼痛)、B 组(术前疼痛且不再术后)和 C 组(术前无痛,术后慢性疼痛)。除了疼痛强度外,还调查了疼痛部位和镇痛药的使用情况。

结果

共有 3279 名患者(83.9%)对调查做出了回应。术前和术后慢性疼痛分别见于 343 名(10.5%)和 264 名(8.1%)患者。在 A 组中,4.8%的患者存在慢性疼痛;在 B 组中,5.7%的患者存在慢性疼痛;在 C 组中,3.3%的患者存在慢性疼痛。此外,4.5%的患者疼痛位于腹部,高于术前(+2.3%,p<0.001)。与术前慢性疼痛、病房时疼痛和术后第 1 天疼痛相比,目前术后慢性疼痛的 OR 分别为 1.45、1.7 和 1.71(p=0.002、0.003、0.003)。在所有参与者中,4.6%的人使用慢性镇痛药。其中,最常使用的是对乙酰氨基酚(3.8%),其次是曲马多(1.3%)和羟考酮(0.5%)。

结论

在这项电子调查中,减重手术后患者的慢性术后腹部疼痛较为突出。在没有术前慢性疼痛的患者中,有 3.3%的患者在手术后出现了慢性疼痛。在被调查人群中,阿片类药物的使用率相对较低。

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