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poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究

近視小伙兒icl隱形眼鏡摘鏡角膜近視手術眼科醫院高度近視激光關念

術后持續疼痛與術后并發癥的關系
【 poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究】 ：一項多中心前瞻性隊列研究
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
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貴州醫科大學 麻醉與心臟電生理課題組
翻譯：胡廷菊 編輯：馬艷燕 審校：曹瑩
摘要
背景：術后持續疼痛是一個棘手的問題，很難處理，且人們對此認識不足。研究發現術后并發癥可能是術后持續疼痛的危險因素。我們對一項關于術前運動耐受測量（METS）的隊列研究進行二次分析，描述術后30天和術后1年持續疼痛和主要并發癥的關系。
方法：這項分析包括行非心臟手術的1313名住院病人（年齡≥40歲），這些病人術后生存期大于1年。共同的主要結局是術后30天疼痛和術后1年疼痛。術后疼痛被定義為疼痛或中到重度不適以及與術前相比疼痛或不適沒有改善。主要暴露是重要的院內并發癥（以改良的Clavien-Dindo標準評為中到重度）。用多變量回歸模型描述調整后的重要并發癥和預后的關系。
摘要
結果：在隊列研究的患者中，12%（n=163）發生了重大并發癥,51%（n=674）發生了術后30天疼痛，42%（n=545）發生了術后1年疼痛。重大并發癥與術后30天疼痛（調整后的優勢比為1.54，95% CI為1.05-2.23）及術后1年疼痛（調整后的優勢比為1.42，95% CI為0.98-2.06）有關。當對缺失的協變量和結果數據進行多重填補后重復分析時，術后并發癥與術后30天和1年疼痛有關。
結論：術后出現重大并發癥的患者更可能存在術后30天或術后1年疼痛。然而，需要更多研究來證實這些發現和描述潛在的機制。
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
文章插圖
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
文章插圖
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
文章插圖
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
文章插圖
poss|【罌粟摘要】術后持續疼痛與術后并發癥的關系：一項多中心前瞻性隊列研究
文章插圖
原始文獻來源：Ciara Hanley , Karim S. Ladha , Hance A. Clarke, et al. Association of postoperative complications with persistent post-surgical pain: a multicentre prospective cohort study. [J] Br J Anaesth. 2022 Feb;128(2):311-320.doi: 10.1016/j.bja.2021.10.027. Epub 2021 Dec 3.
英文原文
Association of postoperative complications with persistent Post-surgical pain: a multicentre prospective cohort study
Background: Persistent post-surgical pain is an important and under-recognised problem that is dificult to treat. Postoperative complications have been identified as possible risk factors for persistent post-surgical pain. We conducted a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) cohort study to characterise the association of major postoperative complications with post-surgical pain at 30 days and 1 yr after major surgery.
Method:The analysis included 1313 participants ( 40 yr old) who had inpatient noncardiac surgery and survived for 1 yr. The co-primary outcomes were 30-day post-surgical pain and 1-yr post-surgical pain. Post-surgical pain was defined as pain or discomfort that was of moderate or severe intensity (EuroQoL-5D [EQ-5D] instrument) and unimproved compared with preoperative pain or discomfort. The principal exposure was major in-hospital complications (moderate or severe by modified Clavien-Dindo criteria). Multivariable logistic regression modelling was used to characterise the adjusted association of major complications with outcomes.
Results:Of the cohort, 12% (n=163) experienced major complications, 51% (n=674) reported 30-day post-surgical pain, and 42% (n=545) reported 1-yr post-surgical pain. Major complications were associated with 30-day post-surgical pain (adjusted odds ratio [aOR]=1.54; 95% confidence interval [CI], 1.05-2.23) and possibly 1-yr post-surgical pain (aOR=1.42; 95% CI, 0.98-2.06). When analyses were repeated after multiple imputation of missing covariate and outcome data, complications were associated with both 30-day and 1-yr post-surgical pain.