Predictive Value of Intraoperative Glucose Variability for Chronic Postsurgical Pain After Arthroscopic Rotator Cuff...

To investigate the predictive value of intraoperative glucose variability (GV) for chronic postsurgical pain (CPSP) in patients undergoing arthroscopic rotator cuff repair (ARCR).

A retrospective study was conducted on 211 ARCR patients admitted to Tongxiang First People's Hospital from January 2021 to December 2024. Patients were divided into CPSP group (n = 35) and non-CPSP group (n = 176). Influencing factors were analyzed with univariate and binary logistic regression. The predictive value of these factors for CPSP in ARCR patients was evaluated with receiver operating characteristic (ROC) curve analysis. Shoulder joint indicators of patients with different levels of intraoperative GV were compared before and after treatment. GV was expressed as the ratio of the standard deviation to the mean value of intraoperative blood glucose.

There were no statistically significant differences (p > 0.05) in age, sex, body mass index (BMI), surgery time, intraoperative blood loss, length of hospital stay, tear location, tear area, glycated hemoglobin (HbA1c), fasting blood glucose and full-thickness tear between the groups. However, there were statistically significant differences (p < 0.05) in the number of torn tendons, shoulder acromioplasty, coefficient of variance (CV), largest amplitude of glycemic excursions (LAGE), and preoperative pain. Binary logistic regression analysis revealed that the number of torn tendons, LAGE, and CV were influencing factors for CPSP in ARCR patients (p < 0.05). The area under the ROC curve for CV was 0.864, standard error 0.027 (95% CI: 0.812-0.916, p < 0.001), with a Youden index of 0.62, sensitivity of 91.43%, and specificity of 70.45%. Post-treatment Constant-Murley Score (CMS) and American Shoulder and Elbow Surgeons Score (ASES) scores were significantly better in patients with CV ≤0.18 compared to CV >0.18 (p < 0.001).

Intraoperative GV has predictive value for CPSP in ARCR patients.