应用 IASP 分级系统识别膝骨关节炎患者的潜在疼痛机制:前瞻性队列研究

IF 3.1 3区 医学 Q2 ANESTHESIOLOGY
Sophie Vervullens, Lotte Meert, Mira Meeus, Christiaan H W Heusdens, Peter Verdonk, Anthe Foubert, Emmanuel Abatih, Lies Durnez, Jonas Verbrugghe, Rob J E M Smeets
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引用次数: 0

摘要

研究目的本研究旨在应用国际疼痛研究协会(IASP)的分级系统识别等待全膝关节置换术(TKA)的膝骨关节炎(KOA)患者的非痉挛性疼痛,并提出调整决策的标准。此外,该研究还旨在利用生物心理社会变量描述 "可能 "与 "无或可能 "的非痉挛性疼痛机制,并比较两组患者在 TKA 术后一年的反应:对一项纵向前瞻性研究的基线数据进行了二次分析,该研究涉及比利时和荷兰197名等待全膝关节置换术的KOA患者。研究采用了两种方法,一种考虑四个疼痛部位,另一种考虑三个疼痛部位(分级系统的第二级)。通过线性混合模型分析,比较了 "可能 "和 "无或可能 "非关节疼痛机制组在术前生物心理社会相关变量和术后一年疼痛方面的情况。此外,还进行了一项敏感性分析,比较了 "可能 "与 "无 "非可塑性疼痛机制组:30名(15.22% - 接近四个疼痛部位)和46名(23.35% - 接近三个疼痛部位)参与者被归类为 "可能 "非整形性疼痛。无论采用哪种疼痛位置方法或敏感性分析,"可能 "非椎体痉挛性疼痛组都比另一组包括更多女性、更年轻、术前各种疼痛相关变量和心理变量结果更差、TKA术后一年疼痛更严重:讨论:本研究提出了更多标准来微调非痉挛性疼痛的分级系统(离散性/区域性/多灶性/广泛性疼痛除外),并描述了 "可能 "存在非痉挛性疼痛的 KOA 患者亚组的特征。今后的研究还需要进一步验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Application of the IASP Grading System to Identify Underlying Pain Mechanisms in Patients With Knee Osteoarthritis: A Prospective Cohort Study.

Application of the IASP Grading System to Identify Underlying Pain Mechanisms in Patients With Knee Osteoarthritis: A Prospective Cohort Study.

Objectives: This study aimed to apply the International Association for the Study of Pain (IASP) grading system for identifying nociplastic pain in knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and propose criteria to fine-tune decision-making. In addition, the study aimed to characterize a "probable" versus "no or possible" nociplastic pain mechanism using biopsychosocial variables and compare both groups in their 1-year post-TKA response.

Methods: A secondary analysis of baseline data of a longitudinal prospective study involving 197 patients with KOA awaiting total TKA in Belgium and the Netherlands was performed. Two approaches, one considering 4 and the other 3 pain locations (step 2 of the grading system), were presented. Linear mixed model analyses were performed to compare the probable and no or possible nociplastic pain mechanism groups for several preoperative biopsychosocial-related variables and 1-year postoperative pain. Also, a sensitivity analysis, comparing 3 pain mechanism groups, was performed.

Results: Thirty (15.22%-approach 4 pain locations) and 46 (23.35%-approach 3 pain locations) participants were categorized under probable nociplastic pain. Irrespective of the pain location approach or sensitivity analysis, the probable nociplastic pain group included more woman, was younger, exhibited worse results on various preoperative pain-related and psychological variables, and had more pain 1-year post-TKA compared with the other group.

Discussion: This study proposed additional criteria to fine-tune the grading system for nociplastic pain (except for discrete/regional/multifocal/widespread pain) and characterized a subgroup of patients with KOA with probable nociplastic pain. Future research is warranted for further validation.

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来源期刊
Clinical Journal of Pain
Clinical Journal of Pain 医学-临床神经学
CiteScore
5.40
自引率
3.40%
发文量
118
审稿时长
4-8 weeks
期刊介绍: ​​​The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.
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