Which patient-specific and surgical characteristics influence postoperative pain after THA in a fast-track setting?

Autor: Stephan B W Vehmeijer, Nick T. van Dasselaar, Yvon M den Hartog, Gerjon Hannink, Nina M C Mathijssen
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Time Factors
Arthroplasty
Replacement
Hip

Osteoarthritis
Preoperative care
Osteoarthritis
Hip

Postoperative pain
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Rheumatology
030202 anesthesiology
Preoperative Care
medicine
Humans
Fast-track
Orthopedics and Sports Medicine
Prospective Studies
Prospective cohort study
Aged
Retrospective Studies
Aged
80 and over

Analgesics
Pain
Postoperative

030222 orthopedics
business.industry
Retrospective cohort study
Perioperative
Middle Aged
medicine.disease
Pain management
3. Good health
Surgery
Multimodal pain protocol
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Neuropathic pain
Physical therapy
Total hip arthroplasty
Female
lcsh:RC925-935
Fast track
business
Research Article
Cohort study
Zdroj: BMC Musculoskeletal Disorders, 18, 363
BMC Musculoskeletal Disorders, 18, 1, pp. 363
BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 18, Iss 1, Pp 1-7 (2017)
ISSN: 1471-2474
DOI: 10.1186/s12891-017-1725-8
Popis: Contains fulltext : 176962.pdf (Publisher’s version ) (Open Access) BACKGROUND: In our hospital a fast-track setting including a multimodal pain protocol is used for total hip arthroplasty (THA). Despite this multimodal pain protocol there is still a large range in reported postoperative pain between patients, which hinders mobilization and rehabilitation postoperatively. The goal of this study was to identify which patient-specific and surgical characteristics influence postoperative pain after THA in a fast-track setting. METHODS: All 74 patients with osteoarthritis of the hip who underwent primary THA procedure by anterior supine intermuscular approach between November 2012 and January 2014 were included in this prospective cohort study. The protocol for pain medication was standardized. Postoperative pain determined with the Numeric Rating Score was collected at 17 standardized moments. Linear mixed models were used to examine potential patient-specific and surgical factors associated with increased postoperative pain. RESULTS: Pain patterns differed substantially across individuals. Adjusted for other variables in the model, preoperative use of pain medication (regression coefficient 0.78 (95% CI 0.28-1.26); p = 0.005) and preoperative neuropathic pain scored by DN4 (regression coefficient 0.68 (95% CI 0.15-1.20); p = 0.02) were the only factors significantly associated with higher postoperative pain scores. CONCLUSIONS: The knowledge of which factors are associated with higher postoperative pain scores after THA in a fast-track setting may help optimizing perioperative postoperative pain management and preoperative education of these patients. TRIAL REGISTRATION: The study was retrospectively registered in the ISRCTN registry under identifier ISRCTN15422220 (date of registration: July 25, 2017).
Databáze: OpenAIRE