Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.
Eur Arch Otorhinolaryngol. 2023 Aug;280(8):3877-3884. doi: 10.1007/s00405-023-07980-4. Epub 2023 Apr 20.
To determine whether the preoperative inflammatory serum C-reactive protein (CRP) and leukocyte count (LEUK) are associated with postoperative pain and complaints after otolaryngological surgery.
Retrospective evaluation of 680 patients (33% female, median age 50 years) receiving otolaryngological surgery between November 2008 and March 2017 in a tertiary university hospital. Postoperative pain on the first postoperative day was assessed using the validated questionnaire of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale for assessment of postoperative pain (NRS, 0-10). The influence of preoperative parameters including CRP and LEUK on patients' postoperative pain was estimated.
Mean CRP value was 15.6 ± 34.6 mg/l and mean LEUK value 7.8 ± 3.2 Gpt/l. Patients with pharyngeal surgery had the highest CRP values (34.6 ± 52.9 mg/l), highest LEUK values (9.2 ± 4.2 Gpt/l) and the highest pain levels (3.1 ± 2.4 NRS) compared to all other surgical procedures (all p < 0.05). Higher postoperative pain was associated with LEUK values > 11.3 Gpt/l (r = 0.093, p = 0.016) and higher preoperative chronic pain (r = 0.127, p = 0.001). Multivariate analysis confirmed younger age, female gender, duration of surgery, preoperative chronic pain, type of surgery, and higher LEUK values > 11.3 as independent factors for postoperative pain. Perioperative antibiotics had no effect on the postoperative pain.
Beyond known factors, preoperative LEUK as inflammation marker is an independent predictor for pain on the first postoperative day.
确定术前炎症血清 C 反应蛋白 (CRP) 和白细胞计数 (LEUK) 是否与耳鼻喉手术后的术后疼痛和不适有关。
回顾性分析 2008 年 11 月至 2017 年 3 月在一家三级大学医院接受耳鼻喉手术的 680 例患者（33%为女性，中位年龄 50 岁）。使用德国术后疼痛治疗质量改进项目（QUIPS）的验证问卷评估术后第 1 天的术后疼痛，包括评估术后疼痛的数字评分量表（NRS，0-10）。估计术前参数（包括 CRP 和 LEUK）对患者术后疼痛的影响。
平均 CRP 值为 15.6±34.6mg/l，平均 LEUK 值为 7.8±3.2Gpt/l。与所有其他手术程序相比，行咽手术的患者 CRP 值最高（34.6±52.9mg/l）、LEUK 值最高（9.2±4.2Gpt/l）和疼痛水平最高（3.1±2.4NRS）（均 p<0.05）。较高的术后疼痛与 LEUK 值>11.3Gpt/l（r=0.093，p=0.016）和较高的术前慢性疼痛（r=0.127，p=0.001）相关。多变量分析证实，年龄较小、女性、手术持续时间、术前慢性疼痛、手术类型和 LEUK 值>11.3 是术后疼痛的独立因素。围手术期使用抗生素对术后疼痛无影响。
除已知因素外，术前 LEUK 作为炎症标志物是术后第 1 天疼痛的独立预测因子。
