Reduced Incidence of Chronic Postsurgical Pain after Epidural Analgesia for Abdominal Surgery
| Autor: | Walther N.K.A. van Mook, H.-F. Gramke, Sabrina A. Bons, Maarten van Kleef, Maurice Theunissen, Marco A. E. Marcus, E. A. Bouman |
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| Přispěvatelé: | RS: SHE - R1 - Research (OvO), MUMC+: MA Anesthesiologie (9), MUMC+: MA AIOS Anesthesiologie (9), Intensive Care, MUMC+: MA Medische Staf IC (9), Anesthesiologie |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors chronic postsurgical pain predictor Quality of life Abdomen Odds Ratio Humans Medicine Prospective Studies Prospective cohort study Aged Pain Measurement Pain Postoperative business.industry Incidence Incidence (epidemiology) Age Factors Chronic pain Odds ratio Middle Aged medicine.disease Surgery Analgesia Epidural epidural Treatment Outcome Anesthesiology and Pain Medicine medicine.anatomical_structure Case-Control Studies Anesthesia Quality of Life Female Chronic Pain business Complication Follow-Up Studies Abdominal surgery |
| Zdroj: | Pain Practice, 14(2), E76-E84. Wiley |
| ISSN: | 1530-7085 |
| DOI: | 10.1111/papr.12091 |
| Popis: | Background Chronic postsurgical pain (CPSP) is a common complication of surgery with high impact on quality of life. Peripheral and central sensitization caused by enhanced and prolonged afferent nociceptive input are considered important mechanisms for the development of CPSP. This case–control study investigated whether epidural analgesia is associated with a reduced incidence of CPSP after open abdominal surgery. Methods Six months after surgery, Short-Form-36 Health Survey (SF-36) pain scores, possible predictors of chronic pain, and quality of life were assessed. Patients treated with epidural analgesia in combination with general anesthesia (epidural group, N = 51) were compared to patients undergoing matched surgical procedures receiving general anesthesia alone (GA-group, N = 50). Multivariate analysis was performed by logistic regression analysis. Results Twenty-six (25.7%) patients experienced chronic pain, 9 in the epidural group (17.6%), 17 in the GA-group (34%), crude odds ratio (OR) 0.42 (95% confidence interval (CI) 0.16 to 1.05). After adjustment for the most prominent predictors of CPSP, such as age, sex, pre-operative pain, and acute postoperative pain, the OR for chronic pain in the epidural group was 0.19 (95% CI 0.05 to 0.76). Patients with CPSP reported a significantly lower quality of life compared to patients without CPSP (SF-36 total score median (IQR) 39.2 (27.2 to 56.7) vs. 84.3 (69.9 to 92.5, P |
| Databáze: | OpenAIRE |
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