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Acute pain after total hip arthroplasty does not predict the development of chronic postsurgical pain 6 months later

机译:全髋关节置换术后的急性疼痛不能预测6个月后慢性术后疼痛的发展

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摘要

Purpose Much remains unknown about the relationship between acute postoperative pain and the development of pathologic chronic postsurgical pain (CPSP). The purpose of this project was to identify the extent to which maximum pain scores on movement over the first two days after total hip arthroplasty predicted the presence of chronic pain 6 months later after controlling for potentially important covariates.Methods The sample comprised 82 of 114 patients who participated in a double-blinded randomized controlled trial in which all patients received acetaminophen 1 g p.o., celecoxib 400 mg p.o., and dexamethasone 8 mg i.v., 1–2 h preoperatively. In addition, patients received gabapentin (GBP) 600 mg (G2) or placebo (G1 and G3) 2 h prior to surgery [G1: placebo/placebo (n = 38); G2: GBP/placebo (n = 38); G3: placebo/GBP (n = 38)]. In the PACU, patients received gabapentin 600 mg (G3) or placebo (G1 and G2). Follow-up data from the 82 patients who were contacted by telephone 6 months postsurgery were used for the current study.Results Maximal movement-evoked pain intensity over the first two postoperative days (P = 0.38) failed to predict the presence of CPSP 6 months later after controlling for age (P = 0.09), treatment group (P = 0.91), and cumulative morphine consumption (P = 0.8) (multivariate logistic regression likelihood ratio test against the intercept only model P = 0.59).Conclusion Neither maximum movement-evoked acute pain, nor any other factor measured, predicted the presence of CPSP at 6 months. Further research is needed to identify risk factors for CPSP after total hip arthroplasty.
机译:目的关于急性术后疼痛与病理性慢性术后疼痛(CPSP)之间的关系,目前尚不清楚。该项目的目的是确定在控制潜在的重要协变量后的6个月后,全髋关节置换术后最初两天最大运动疼痛评分预测了慢性疼痛的存在程度。方法该样本包括114例患者中的82例他们参加了一项双盲随机对照试验,其中所有患者在术前1-2小时接受口服对乙酰氨基酚1 g po,塞来昔布400 mg po和地塞米松8 mg iv。此外,患者在手术前2小时接受加巴喷丁(GBP)600 mg(G2)或安慰剂(G1和G3)[G1:安慰剂/安慰剂(n = 38); G2:英镑/安慰剂(n = 38); G3:安慰剂/ GBP(n = 38)]。在PACU中,患者接受加巴喷丁600 mg(G3)或安慰剂(G1和G2)。本研究采用了术后6个月通过电话联系的82例患者的随访数据。结果术后前两天最大的运动诱发疼痛强度(P = 0.38)无法预测6个月CPSP的存在在控制了年龄(P = 0.09),治疗组(P = 0.91)和吗啡的累积消费量(P = 0.8)之后(针对仅截距模型P的多变量logistic回归似然比检验P = 0.59)。诱发急性疼痛,也未测量任何其他因素,可预测6个月时CPSP的存在。全髋关节置换术后需要进一步研究确定CPSP的危险因素。

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