Sonobe Tatsuru, Nikaido Takuya, Sekiguchi Miho, Kaneuchi Yoichi, Kikuchi Tadashi, Matsumoto Yoshihiro
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
Department of Orthopaedic Surgery, Bange-Kosei General Hospital, Fukushima, Japan.
J Pain Res. 2025 Mar 19;18:1407-1415. doi: 10.2147/JPR.S511719. eCollection 2025.
Total knee arthroplasty (TKA) is an effective treatment for relieving pain and restoring physical function in individuals with severe knee osteoarthritis (KOA). However, the persistence of postoperative pain is an unresolved problem, and the use of postoperative analgesics to deal with this pain is increasing. The positive cognitive factor known as pain self-efficacy (PSE) has been shown to moderate the intensity of pain, but there are few reports of PSE concerning analgesic use after TKA. We sought to clarify the effect of PSE on postoperative analgesic use in TKA cases.
We conducted a retrospective cohort study of 60 patients who underwent bilateral TKA surgery for bilateral severe KOA. A multiple linear regression model including covariates and scaling estimation coefficients was used to investigate the effect of PSE on the patients' postoperative analgesic use. We identified the presence/absence of postoperative analgesic use at 3 and 6 months postoperatively, and other evaluation items such as the Pain Self-Efficacy Questionnaire (PSEQ) were evaluated at the time of the patients' admission for surgery.
In a multiple linear regression model, only high PSE had a significant impact on the postoperative 3-month use of nonsteroidal anti-inflammatory drugs (NSAIDs) (β: -0.27, 95% confidence interval [CI]: -0.51, -0.01). However, the significant difference had disappeared postoperative 6 months (β: -0.06, 95% CI: -0.19, 0.31).
These results demonstrated that high pain self-efficacy reduced the analgesic use at 3 months postoperatively by patients who have undergone bilateral TKA surgery, but it did not affect analgesic use at 6 months postoperatively. Pain self-efficacy can be an intervention target for reducing the use of analgesics after TKA surgery. Further research is needed to clarify the relationship between pain self-efficacy and the post-TKA use of analgesics.
全膝关节置换术（TKA）是缓解重度膝骨关节炎（KOA）患者疼痛和恢复身体功能的有效治疗方法。然而，术后疼痛持续存在是一个尚未解决的问题，用于处理这种疼痛的术后镇痛药的使用正在增加。被称为疼痛自我效能感（PSE）的积极认知因素已被证明可调节疼痛强度，但关于TKA术后镇痛药使用的PSE报告很少。我们试图阐明PSE对TKA病例术后镇痛药使用的影响。
我们对60例因双侧重度KOA接受双侧TKA手术的患者进行了一项回顾性队列研究。使用包括协变量和标度估计系数的多元线性回归模型来研究PSE对患者术后镇痛药使用的影响。我们确定了术后3个月和6个月是否使用术后镇痛药，并且在患者手术入院时评估了其他评估项目，如疼痛自我效能量表（PSEQ）。
在多元线性回归模型中，只有高PSE对术后3个月非甾体抗炎药（NSAIDs）的使用有显著影响（β：-0.27，95%置信区间[CI]：-0.51，-0.01）。然而，术后6个月显著差异消失（β：-0.06，95%CI：-0.19，0.31）。
这些结果表明，高疼痛自我效能感降低了接受双侧TKA手术患者术后3个月的镇痛药使用，但对术后6个月的镇痛药使用没有影响。疼痛自我效能感可以成为减少TKA手术后镇痛药使用的干预靶点。需要进一步研究以阐明疼痛自我效能感与TKA术后镇痛药使用之间的关系。
