在同一天手术中慢性术后疼痛的发生率和危险因素:前性队列研究
Melodie Fanay Boko1, Ashish K Khanna2, Frederick D'Aragon3
1Department of Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.
Anesthesiology
|April 26, 2024
概括
同一天手术后的慢性术后疼痛是常见的,影响到12%的患者,通常是中度到严重的. 这种持续性疼痛主要影响没有先前慢性疼痛疾病的个体.
科学领域:
- 疼痛医学 医学 疼痛医学
- 外科手术的结果
- 流行病学 流行病学
背景情况:
- 在全球范围内,同一天手术率显著增加.
- 门诊手术后慢性术后疼痛的证据有限.
- 了解疼痛轨迹在外科手术后,对于患者的护理至关重要.
研究的目的:
- 为了评估慢性术后疼痛 (CPP) 的发生率和特征,在门诊手术后90天.
- 为了确定与这种患者群体中发展CPP相关的风险因素.
- 为了评估在同一天接受手术的患者中CPP的严重程度.
主要方法:
- 进行了一项国际性的多中心前性队列研究.
- 包括45岁以上有并发症或65岁以上的患者.
- 使用简要疼痛清单评估疼痛,将CPP定义为疼痛部位疼痛增加>1点,中度至重度CPP定义为90天后得分>4.
主要成果:
- 在2,054名参与者中,有12%的人患上了CPP,其中93.1%的人经历了新的疼痛发作.
- 中度至重度的CPP发生在9%的参与者身上.
- 风险因素包括积极吸烟,骨科,塑料,乳腺和血管外科手术,以及西班牙裔/拉丁裔或第一民族/土著族裔.
结论:
- 持续的术后疼痛是同一天的门诊手术后的常见结果.
- 大多数CPP病例是新发病,中度至重度.
- 确定特定的外科手术程序和患者人口统计数据可以帮助预测CPP风险.
更多相关视频
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
78
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
78
Local Anesthetics: Clinical Application as Epidural Anesthesia
429
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
429
Endoscopic Procedures II: Colonoscopy
90
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
90
General Anesthesia: Overview
214
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
214
Analgesia and Pain Management
585
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
585
Appendicitis-II: Diagnostic Studies and Management
77
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
77


