Abstract:
BACKGROUND:Approximately 15% of patients report persistent knee pain despite surgical success following total knee arthroplasty (TKA). The purpose of this study was to determine the association of acute-postsurgical pain (APSP) with chronic postsurgical pain (CPSP) 6 months after TKA controlling for patient, surgical and psychological confounding factors. METHODS:Adult patients with osteoarthritis undergoing primary elective tricompartmental TKA, with the operated knee the primary source of preoperative pain, were studied between March 2011 and February 2017. Patients received standard operative management and a perioperative multimodal analgesia regimen. The primary outcome was CPSP at 6 months. The primary variable of interest was the APSP (weighted mean pain score) for 72 hours postoperatively. Patient, surgical and psychological confounders were assessed using binary logistic regression. RESULTS:245 cases were analyzed. The incidence of CPSP was 14% (95% CI 10% to 19%). Median APSP values were 4.2 (2.2-5.0) in the CPSP group and 2.8 (1.8-3.7) without CPSP, difference 1.4 (95% CI 0.1 to 1.8, p=0.005). The unadjusted odds for CPSP with an increase of 1 in APSP was 1.46 (95% CI 1.14 to 1.87, p=0.002)). After multivariable risk adjustment, the OR for CPSP for an increase of 1 in the APSP was 1.53 (95% CI 1.12 to 2.09, p=0.008). CONCLUSIONS:APSP is a risk factor for CPSP following TKA even after adjusting for confounding variables such as pain catastrophizing, anxiety, depression and functional status. Studies are needed to determine if APSP is a modifiable risk factor for the development of CPSP.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Buvanendran A,Della Valle CJ,Kroin JS,Shah M,Moric M,Tuman KJ,McCarthy RJdoi
10.1136/rapm-2018-100036subject
Has Abstractpub_date
2019-02-15 00:00:00eissn
1098-7339issn
1532-8651pii
rapm-2018-100036pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVE:Long-acting nociceptive-selective regional anesthesia has remained an elusive clinical goal. We aspired to identify a novel compound that would produce nociceptive-selective regional anesthesia through the transient receptor potential vanilloid 1 (TRPV1) channels. METHODS:We designed and synth...
journal_title:Regional anesthesia and pain medicine
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abstract::Shoulder surgery is associated with significant postoperative pain in many patients. The use of an interscalene nerve block offers good analgesia but is associated with a high incidence of an ipsilateral phrenic nerve block. Several strategies to avoid this adverse effect have been studied. Possible strategies are (1)...
journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
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