Fu Qiuyue, Han Mingming, Mu Yuyang, Hao Lina, Lu Liang, Huang Xiang, Li Juan, Kang Fang
Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China.
Department of Hand and Foot Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China.
Front Surg. 2023 Feb 27;10:1102319. doi: 10.3389/fsurg.2023.1102319. eCollection 2023.
Tourniquet pain is the most prominent problem in ankle surgery, and there is no proper method to predict it. It was reported that pain sensitivity questionnaires could evaluate the pain sensitivity of subjects. Its potential to predict tourniquet pain in ankle surgery is constructive and meaningful.
One hundred and twenty patients undergoing ankle surgery were included in this study. The pain sensitivity questionnaire (PSQ) and self-rating anxiety scale (SAS) were completed before the operation. The methods included an ultrasound-guided popliteal sciatic, a femoral nerve block, and a proximal thigh tourniquet. The pressure of the tourniquet was set according to the systolic blood pressure (SBP + 100 mmHg). A visual analogue scale (VAS) was used to assess the tourniquet pain. Also, the onset time of tourniquet pain ≥4 VAS units was recorded.
The PSQ-total and PSQ-minor scores were significantly correlated with the onset time when the tourniquet pain ≥4 VAS units ( = -0.763, = -0.731, < 0.001). The PSQ-total score <6.5 group gave significantly lower ratings for items 3, 4, 14, and 16 in the PSQ survey compared to the PSQ-total score ≥6.5 group ( < 0.05). Patients with high pain sensitivity have a higher need for analgesic drugs ( < 0.001). PSQ-total score ≥6.5 (OR = 185.8, 95% CI = 39.8-1,437.6, < 0.001), sex (male, OR = 0.11, 95% CI = 0.018-0.488, < 0.05), and age (OR = 0.92, 95% CI = 0.842-0.995, < 0.05) were risk factors for reporting a tourniquet pain ≥4 VAS units within 30 min.
The PSQ score is found to be correlated with intraoperative tourniquet pain. In addition, sex and age also affect the time of having intraoperative tourniquet pain.
止血带疼痛是踝关节手术中最突出的问题，目前尚无合适的方法来预测它。据报道，疼痛敏感性问卷可以评估受试者的疼痛敏感性。其预测踝关节手术中止血带疼痛的潜力具有建设性和意义。
本研究纳入了120例接受踝关节手术的患者。术前完成疼痛敏感性问卷（PSQ）和自评焦虑量表（SAS）。方法包括超声引导下腘坐骨神经阻滞、股神经阻滞和大腿近端止血带。止血带压力根据收缩压（SBP + 100 mmHg）设定。采用视觉模拟评分法（VAS）评估止血带疼痛。同时，记录止血带疼痛≥4 VAS单位的发作时间。
当止血带疼痛≥4 VAS单位时，PSQ总分和PSQ小分与发作时间显著相关（r = -0.763，r = -0.731，P < 0.001）。与PSQ总分≥6.5组相比，PSQ总分<6.5组在PSQ调查中的第3、4、14和16项评分显著较低（P < 0.05）。疼痛敏感性高的患者对镇痛药的需求更高（P < 0.001）。PSQ总分≥6.5（OR = 185.8，95% CI = 39.8 - 1437.6，P < 0.001）、性别（男性，OR = 0.11，95% CI = 0.018 - 0.488，P < 0.05）和年龄（OR = 0.92，95% CI = 0.842 - 0.995，P < 0.05）是在30分钟内报告止血带疼痛≥4 VAS单位的危险因素。
发现PSQ评分与术中止血带疼痛相关。此外，性别和年龄也会影响术中止血带疼痛的发生时间。
