摘要
目的筛选单侧全膝关节置换术后急性疼痛的危险因素。方法 2019年5月至2019年12月择期全麻下行首次单侧全膝关节置换术患者,收集术前一般资料以及PainDETECT量表评分、西安大略麦克马斯特大学骨关节炎评分、焦虑抑郁量表评分、VAS评分、是否服用阿片类药物;术中使用止血带时间以及麻醉药物使用情况;术后24 h内记录膝关节VAS评分,将患者分为2组,VAS评分≤3分为轻度疼痛组(L组),VAS评分>3分为中至重度疼痛组(H组),将组间比较差异有统计学意义的因素进行logistic回归分析,筛选单侧全膝关节置换术后急性疼痛的危险因素。结果共143例患者纳入本研究,其中L组60例,H组83例,术后中到重度急性疼痛发生率为58%。患者术前VAS评分、焦虑状态、并存神经病理性疼痛及术中使用止血带时间是单侧全膝关节置换术后急性疼痛的危险因素(P<0.05)。结论术前VAS评分、焦虑状态、并存神经病理性疼痛和术中使用止血带时间是单侧全膝关节置换术后急性疼痛的危险因素。
Objective To identify the risk factors for acute pain after unilateral total knee arthroplasty(TKA).Methods Patients who underwent the elective first unilateral TKA under general anesthesia from May 2019 to December 2019 were collected.Preoperative baseline characteristics,PainDetect questionnaire score,the Western Ontario McMaster Universities Osteoarthritis Index score,the hospital anxiety and depression score,visual analogue scale(VAS)score,whether or not opioids was administered;intraoperative duration of tourniquet use,and use of anesthetics were recorded.The knee VAS score within 24 h after surgery was recorded.Patients were assigned to 2 groups according to postoperative knee VAS score:mild pain(VAS≤3)group(group L)and moderate to severe pain(VAS>3)group(group H).The factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify the risk factors for acute pain after unilateral TKA.Results A total of 143 patients were included in this study,including 60 patients in group L and 83 patients in group H.The incidence of moderate to severe acute pain after surgery was 58%.Preoperative VAS score,anxiety status,coexisting neuropathic pain and intraoperative duration of tourniquet use were the risk factors for acute pain after unilateral TKA(P<0.05).Conclusion Preoperative VAS score,anxiety state,coexisting neuropathic pain and intraoperative duration of tourniquet use are the risk factors for acute pain after unilateral TKA.
作者
陈帆
柴小青
王迪
杨歆璐
高玮
胡继成
Chen Fan;Chai Xiaoqing;Wang Di;Yang Xinlu;Gao Wei;Hu Jicheng(Department of Anesthesiology,Affiliated Provincial Hospital,Anhui Medical University,Hefei 230001,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2020年第11期1328-1331,共4页
Chinese Journal of Anesthesiology
基金
吴阶平医学基金会临床科研专项资助基金资助(320.6750.16166)
安徽省重点研究与开发计划项目资助(1804h08020286)。
关键词
关节成形术
置换
膝
手术后并发症
疼痛
危险因素
Arthroplasty,replacement,knee
Postoperative complications
Pain risk factors
