Ioannidis Rafail, Sarridou Despoina, Tsigalou Christina, Bampoulas Adamantios, Chloropoulou Pelagia
Anesthesiology and Pain Medicine Department, General Hospital of Drama, Drama, Greece.
Anesthesiology and Intensive Care Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Anesthesiol Res Pract. 2025 Aug 28;2025:6832202. doi: 10.1155/anrp/6832202. eCollection 2025.
Nutritional screening is gaining recognition in perioperative medicine, as anesthesiologists need to assess patients' nutritional status to identify malnutrition risks. Poor nutritional status is associated with increased perioperative complications, including postoperative pain. Effective pain management is crucial to prevent acute pain from developing into chronic pain. However, the link between malnutrition and pain is not well established, prompting interest in whether nutritional assessment tools correlate with pain severity. The Mini Nutritional Assessment Short-Form (MNA-SF) is a validated screening tool for geriatric patients, recommended by European Society for Clinical Nutrition and Metabolism (ESPEN) for routine use. The modified Nutrition Risk in Critically Ill (mNUTRIC) score evaluates critically ill patients' nutritional risk, guiding interventions to improve outcomes. This study aimed to explore the relationship between nutritional status, inflammatory markers, and postoperative pain in elderly surgical patients to optimize care. A prospective study involving 108 elderly patients (≥ 70 years) assessed the preoperative nutritional status using MNA-SF, mNUTRIC, Acute Physiology and Chronic Health Evaluation (APACHE), Sequential Organ Failure Assessment (SOFA), and inflammatory biomarkers (C-reactive protein (CRP) and albumin (Alb)). Postoperative pain was measured at surgery, 30 days, and 6 months. Statistical analysis found significant links between the nutritional status and pain outcomes. Higher mNUTRIC and APACHE scores correlated with increased pain, while higher Alb and MNA-SF scores were associated with lower pain levels. Chronic pain at 6 months was strongly linked to poor preoperative nutritional and inflammatory status. Findings suggest that nutritional deficiencies and inflammation are associated with postoperative pain and recovery. Integrating nutritional screening into preoperative assessments could improve outcomes by guiding interventions. Future research should refine predictive models to better understand the complex interplay between nutrition, inflammation, and pain in perioperative care. ClinicalTrials.gov identifier: NCT06802575.
营养筛查在围手术期医学中越来越受到认可，因为麻醉医生需要评估患者的营养状况以识别营养不良风险。营养状况不佳与围手术期并发症增加有关，包括术后疼痛。有效的疼痛管理对于防止急性疼痛发展为慢性疼痛至关重要。然而，营养不良与疼痛之间的联系尚未完全明确，这引发了人们对营养评估工具是否与疼痛严重程度相关的兴趣。微型营养评定简表（MNA-SF）是一种经过验证的老年患者筛查工具，被欧洲临床营养与代谢学会（ESPEN）推荐用于常规使用。改良的危重症患者营养风险（mNUTRIC）评分评估危重症患者的营养风险，指导干预措施以改善预后。本研究旨在探讨老年外科患者的营养状况、炎症标志物与术后疼痛之间的关系，以优化护理。一项涉及108名老年患者（≥70岁）的前瞻性研究，使用MNA-SF、mNUTRIC、急性生理与慢性健康状况评估（APACHE）、序贯器官衰竭评估（SOFA）以及炎症生物标志物（C反应蛋白（CRP）和白蛋白（Alb））评估术前营养状况。在手术时、术后30天和6个月测量术后疼痛。统计分析发现营养状况与疼痛结局之间存在显著关联。较高的mNUTRIC和APACHE评分与疼痛增加相关，而较高的Alb和MNA-SF评分与较低的疼痛水平相关。6个月时的慢性疼痛与术前不良的营养和炎症状态密切相关。研究结果表明，营养缺乏和炎症与术后疼痛及恢复有关。将营养筛查纳入术前评估可通过指导干预措施改善预后。未来的研究应完善预测模型，以更好地理解围手术期护理中营养、炎症和疼痛之间的复杂相互作用。ClinicalTrials.gov标识符：NCT06802575。
