BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating...BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.展开更多
目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试...目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试验且使用干针作为主要治疗手段,并纳入诊断为膝关节疾病的患者。由2位评估人独立筛选文章,对方法学质量进行评分,并提取数据。主要指标有目测类比评分,次要指标主要有西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、压痛阈值、膝关节活动度和Kujala评分(膝关节功能评分量表)。结果:Meta分析共纳入15项随机对照试验,涉及698例患者。Meta分析结果显示,与非干针治疗组相比,干针治疗组目测类比评分、WOMAC疼痛评分与WOMAC僵硬度评分存在明显优势(MD=-0.63,95%CI:-1.06至-0.19,P=0.005;MD=-0.74,95%CI:-1.32至-0.17,P=0.01;MD=-0.43,95%CI:-0.77至-0.09,P=0.01),WOMAC总评分、WOMAC功能评分、压痛阈值、膝关节活动度、Kujala评分没有明显优势。结论:干针可以有效治疗膝关节疼痛和僵硬度,然而在改善其他膝关节功能障碍方面的临床优势及随访效果证据不足。所以,对于一些年龄较大患有膝关节慢性疼痛或关节僵硬的患者,可以谨慎考虑使用干针治疗。展开更多
文摘BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.
文摘目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试验且使用干针作为主要治疗手段,并纳入诊断为膝关节疾病的患者。由2位评估人独立筛选文章,对方法学质量进行评分,并提取数据。主要指标有目测类比评分,次要指标主要有西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、压痛阈值、膝关节活动度和Kujala评分(膝关节功能评分量表)。结果:Meta分析共纳入15项随机对照试验,涉及698例患者。Meta分析结果显示,与非干针治疗组相比,干针治疗组目测类比评分、WOMAC疼痛评分与WOMAC僵硬度评分存在明显优势(MD=-0.63,95%CI:-1.06至-0.19,P=0.005;MD=-0.74,95%CI:-1.32至-0.17,P=0.01;MD=-0.43,95%CI:-0.77至-0.09,P=0.01),WOMAC总评分、WOMAC功能评分、压痛阈值、膝关节活动度、Kujala评分没有明显优势。结论:干针可以有效治疗膝关节疼痛和僵硬度,然而在改善其他膝关节功能障碍方面的临床优势及随访效果证据不足。所以,对于一些年龄较大患有膝关节慢性疼痛或关节僵硬的患者,可以谨慎考虑使用干针治疗。
