Perioperative Risk Factors for Chronic Pain after Primary Unilateral Total Knee Arthroplasty
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0612
- VernacularTitle:初次单侧全膝关节置换术后慢性疼痛围术期危险因素分析
- Author:
Jing-jun ZHANG
1
;
Cheng-jie LIANG
1
;
Wei-hong LI
1
;
Jie YU
1
;
Pei-hui WU
2
;
Ke AN
1
;
Lai-bao SUN
1
Author Information
1. Department of Anesthesiology， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
2. Department of Orthopedics， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
total knee arthroplasty;
chronic postoperative pain;
neuropathic pain
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):906-912
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the incidence， severity and nature of chronic postoperative pain （CPSP） after primary unilateral total knee arthroplasty （TKA）， and to screen the possible non-surgery factors leading to CPSP following TKA. MethodsA total of 380 patients who received primary unilateral TKA in our center were selected. Retrospective telephone questionnaire， numeric rating scales （NRS） and ID pain subscale were used to calculate the degree and nature of pain 3 months after operation， and perioperative information was also collected. Binary logistic regression analysis was used to screen the possible independent risk factors for CPSP after TKA. ResultsA total of 338 patients were included （ the lost follow-up rate =11.05%.）. Among them， 141 cases of TKA patients had experienced CPSP 3 months after operation（41.7%）；85 cases of patients were affected by the daily activities of CPSP（25.1%）， and 57 cases caused sleep disorders（16.9%）. The nature of pain in patients （52 cases，15.4%） was suspected neuropathic pain （NP）. Among the 24 non-operative factors during perioperative period， high preoperative NRS score of knee joint， low effective compression rate of patient-controlled analgesia pump， swelling of knee joint 3 months after operation and low level of C-reactive protein（CRP）3 days after operation were independent risk factors for CPSP after TKA （P＜0.05）. ConclusionsThe incidence rate of CPSP in patients with primary unilateral TKA was still higher 3 months after operation， in which 15.4% of cases are suspected as neuropathic pain. High preoperative NRS， low postoperative CRP level， postoperative knee joint swelling and low effective compression rate of self-controlled analgesia pump are the independent risk factors for CPSP after TKA. Perioperative pain management should be further improved to reduce the incidence of CPSP after TKA.
