Thermal Quantitative Sensory Testing to Predict Postoperative Pain Outcomes Following Gynecologic Surgery
Thermal Quantitative Sensory Testing to Predict Postoperative Pain Outcomes Following Gynecologic Surgery
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DOI：
10.1111/pme.12374
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发表时间：
2014-05-01
期刊：
影响因子：
3.1
通讯作者：
McCarthy, Robert J.
中科院分区：
文献类型：
--
作者：
Ahmad, Shireen;De Oliveira, Gildasio S., Jr.;McCarthy, Robert J.
目的评价妇科手术后阿片类药物未成熟患者的术前热定量感觉测试(QST)值与术后疼痛及阿片类药物用量的关系。设计单盲观察研究。疼痛结果在到达麻醉后护理病房时进行评估，每隔6小时评估一次，持续24小时。受试者被重新分为三组：组1的热痛阈值高于中位数，冷痛阈值低于中位数；组2的热痛阈值低于中位数，冷痛阈值高于中位数；组3的热痛阈值低于中位数，冷痛阈值高于中位数。主要结果是24小时吗啡消耗量。结果120名受试者被评估。中位数(四分位数范围)热和冷痛阈值分别为44.8(42.4-46.9)摄氏度和10.5(3.2-19.0)摄氏度。热痛觉阈值与24小时吗啡用量呈负相关(Rho=-0.23，P=0.01)，冷痛阈值与24小时吗啡用量呈正相关(Rho=0.21，P=0.02)。热痛阈值为10摄氏度的受试者(N=46)比热痛阈值为45摄氏度和冷痛阈值为45摄氏度的受试者的吗啡消耗量中位数高19(2-33)毫克(P=0.004)
ObjectiveTo evaluate the relationship of preoperative thermal quantitative sensory testing (QST) values with postoperative pain and opiate consumption in opiate-naive patients following gynecologic surgery.DesignSingle blind observational study.SettingsSurgical center of an academic medical center.MethodsQST was performed preoperatively on 124 opioid-naive patients. Pain outcomes were assessed on arrival to the post-anesthesia care unit and at 6 hourly intervals for 24 hours. Subjects were reclassified to three groups: Group 1 had a heat pain threshold above and a cold pain threshold below the median; Group 2 had either a heat pain threshold below or a cold pain threshold above the median; Group 3 had a heat pain threshold below and a cold pain threshold above the median. The primary outcome measure was the 24-hour morphine consumption.ResultsOne hundred twenty subjects were evaluated. Median (interquartile range) warm and cold pain thresholds were 44.8 (42.4-46.9)degrees C and 10.5 (3.2-19.0)degrees C, respectively. Heat pain thresholds demonstrated a negative (rho=-0.23, P=0.01) and cold thresholds a positive correlation (rho=0.21, P=0.02) with 24-hour morphine consumption. Median morphine consumption was 19 (2-33) mg (P=0.004) equivalents greater in subjects (N=46) with heat pain thresholds 10 degrees C than subjects with heat pain thresholds >45 degrees C and cold pain thresholds