中枢致敏对TKA围手术期疼痛的影响:一项回顾性队列研究。

IF 4.4 Q2 Medicine
Tatsuru Sonobe, Takuya Nikaido, Miho Sekiguchi, Yoichi Kaneuchi, Tadashi Kikuchi, Yoshihiro Matsumoto
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引用次数: 0

摘要

背景:全膝关节置换术(TKA)是治疗严重膝骨关节炎(KOA)的一种成熟的手术方法,具有良好的疗效。虽然有几项研究报道,术前中枢致敏(CS)患者经历了更严重的术前和术后疼痛和结果,但证据有限。我们进行了这项研究,以确定CS对严重KOA TKA患者围术期膝关节疼痛的影响。方法:对66例因双侧严重KOA行双侧TKA的患者进行回顾性队列研究。采用多元线性回归模型,包括协变量和尺度估计回归系数,检验CS对患者术前和术后疼痛亚量表值对膝关节损伤和骨关节炎结局评分(kos)的影响,以及对kos疼痛的改善。术后3个月评估术后kos疼痛,入院时评估术前kos疼痛、CS、疼痛自我效能感等评估项目。结果:CS对术前和术后kos疼痛有负面影响(术前,β: -0.28, 95%可信区间[CI] -18.53, -0.92;术后,β: -0.26, 95%CI -14.09, -0.44;p结论:这些结果表明,CS对患者tka前后膝关节疼痛有负面影响,但不影响膝关节疼痛的改善。TKA可充分缓解严重KOA的疼痛,无论有无CS。需要进一步的研究来改善KOA合并CS患者的术前和术后膝关节疼痛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study.

The impact of central sensitization on perioperative pain in TKA: a retrospective cohort study.

Background: Total knee arthroplasty (TKA) is an established surgical procedure for severe knee osteoarthritis (KOA) that has provided excellent outcomes. While several studies have reported that patients with preoperative central sensitization (CS) experienced worse pre- and post-operative pain and outcomes, the evidence is limited. We conducted this study to determine the impact of CS on perioperative knee pain in TKA for severe KOA.

Methods: A retrospective cohort study of 66 patients who underwent bilateral TKA for bilateral severe KOA was conducted. Multiple linear regression models that included covariates and scaled estimated regression coefficients were used to examine the impact of CS on the patients' pre- and post-operative pain subscale values on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the improvement of KOOS pain. Postoperative KOOS pain was assessed at 3 months postoperatively, while other evaluation items including preoperative KOOS pain, CS, and pain self-efficacy were assessed on admission.

Results: CS had a negative impact on pre- and post-operative KOOS pain (preoperative, β: -0.28, 95% confidence interval [CI] -18.53, -0.92; postoperative, β: -0.26, 95%CI -14.09, -0.44; p < 0.05). High pain self-efficacy had a positive impact on preoperative KOOS pain (β: 0.25, 95%CI 0.32, 18.08; p < 0.05). However, CS did not influence the improvement of KOOS pain.

Conclusions: These results demonstrate that CS had a negative impact on pre- and post-TKA knee pain in patients but did not affect the improvement of knee pain. TKA provides sufficient pain relief for severe KOA, with or without CS. Further research is required to improve pre- and post-operative knee pain in KOA patients with CS.

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来源期刊
CiteScore
6.50
自引率
0.00%
发文量
42
审稿时长
19 weeks
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