Elevated postoperative pain levels following orthopedic surgery. Depression as a strong predictor
Elevated postoperative pain levels following orthopedic surgery. Depression as a strong predictor
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DOI：
10.1007/s00482-009-0883-5
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发表时间：
2010-02-01
期刊：
影响因子：
1
通讯作者：
Faller, H.
中科院分区：
文献类型：
--
作者：
Goebel, S.;Baumann, B.;Faller, H.
本研究的目的是研究抑郁症是否是骨科手术后疼痛水平升高的一个强有力的预测因素，以及实施标准化的疼痛管理是否对抑郁症患者更有益。我们对两组接受骨科手术的患者进行了一项非随机的前瞻性研究。组1 （n = 249）接受非标准化疼痛治疗，组2 （n = 243）接受标准化疼痛管理概念治疗。采用基于vas的疼痛评估方案监测治疗效果。术前采用患者健康问卷（PHQ-9）自报抑郁程度。可能诊断为重度抑郁发作的患者术后疼痛明显高于无抑郁发作的患者。另一方面，抑郁症患者受益于标准化疼痛管理的实施。我们的数据提示抑郁对严重术后疼痛的预测价值。抑郁症患者从标准化的术后疼痛治疗中获益，但术后疼痛仍明显加重。
The aim of this study was to examine whether depression is a strong predictor of elevated postoperative pain levels following orthopedic surgery and whether the implementation of standardized pain management is more beneficial for patients with depression. We performed a non-randomized, prospective study with two different groups of patients who underwent orthopedic surgery. Group 1 (n = 249) received non-standardized pain therapy whereas group 2 (n = 243) was treated with a standardized pain management concept. Effects of the treatment were monitored with a VAS-based pain assessment protocol. Depression was measured preoperatively with the self-reported Patient Health Questionnaire (PHQ-9). Patients with the probable diagnosis of a current episode of major depression showed significantly higher postoperative pain than patients without a depressive episode. On the other hand, patients with depression benefited from the implementation of standardized pain management. Our data suggest a predictive value of depression for severe postoperative pain. Patients with depression benefited from standardized postoperative pain therapy, but were still suffering from significantly higher postoperative pain.