在腹部手术后的术后急性疼痛轨迹和慢性术后疼痛:前性队列研究和调解分析
Dong Xu Chen1,2, Yu Yang Zhang3, Jing Liu3
1Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, China.
International journal of surgery (London, England)
|February 4, 2025
概括
急性术后疼痛轨迹显著预测慢性术后疼痛 (CPSP) 的风险. 运动或休息期间的高疼痛强度几乎使CPSP风险增加了一倍,突出了针对性疼痛管理策略的必要性.
科学领域:
- 疼痛研究 疼痛研究
- 外科手术的结果
- 临床疼痛管理 临床疼痛管理
背景情况:
- 在腹部手术后,急性术后疼痛是常见的.
- 了解疼痛轨迹对于预测慢性疼痛发展至关重要.
- 慢性术后疼痛 (CPSP) 对患者来说是一个重大的长期挑战.
研究的目的:
- 为了确定在腹部手术后的前5天内明显的急性术后疼痛强度轨迹.
- 分析这些疼痛轨迹与发展CPSP的风险之间的关联.
- 探索这种关联中恢复质量和亚急性疼痛的调解作用.
主要方法:
- 预期招募接受选择性腹部手术的患者.
- 在手术后的前5天,每天记录疼痛强度测量.
- 潜在类分析以确定疼痛轨迹;调解分析以确定恢复质量和亚急性疼痛.
主要成果:
- 分析了1170名患者;确定了两个主要的疼痛轨迹集群:高和低疼痛,运动和静止.
- 高疼痛轨迹组 (运动或休息) 的患者患CPSP的风险几乎翻了一番 (分别为2.04和1.90).
- 恢复质量差和较高的亚急性疼痛显著介导了不良急性疼痛轨迹和CPSP之间的联系.
结论:
- 术后疼痛轨迹概况是临床上显著的CPSP风险预测指标.
- 急性疼痛轨迹是一个关键指标,亚急性疼痛作为一个重要的调解者.
- 专注于急性疼痛轨迹的量身定制的疼痛管理策略可能会减少CPSP的发生率.
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