Day-to-day experience in resolution of pain after surgery.
Day-to-day experience in resolution of pain after surgery.
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DOI：
10.1097/j.pain.0000000000001015
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发表时间：
2017-11
期刊：
影响因子：
7.4
通讯作者：
Eisenach JC
中科院分区：
文献类型：
--
作者：
Houle TT;Miller S;Lang JE;Booth JL;Curry RS;Harris L;Aschenbrenner CA;Eisenach JC
我们对病人在出院后的第一个星期从手术中恢复的个体疼痛体验知之甚少。在这里，我们研究了两种大手术后日常体验的个体差异：下肢全大关节置换术（TJA）和剖宫产（CD）。研究招募了55名TJA患者和157名CD患者完成问卷调查，并记录他们术后的日常疼痛经历。出院后，患者记录疼痛强度，每天1次，连续60天（CD）或每天2次，连续2周，每天1次，连续8周，每周一次，连续3个月（TJA）。疼痛评分采用生长曲线和贝叶斯变点模型建模。研究人员检查了模型拟合中的个体差异，以寻找日常疼痛差异的证据。对数时间模型是拟合数据的最简单模型，但对残差的检查显示高度自相关表示错误规范。变化点模型更好地拟合了数据，并显示恢复的形式在手术后10天至21天之间发生了根本性的变化。这些数据有意义地增加了我们对术后疼痛恢复的理解，将术后几天的频繁观察延长到2个月。这些高时间分辨率的数据表明，手术后存在典型的疼痛缓解体验，但可能存在有意义的体验亚群。他们还指出，手术后1个月内，疼痛会随着时间从一种模式转变为另一种模式。
We know little about the individual pain experience of patients recovering from surgery in the first weeks after hospital discharge. Here, we examine individual differences in the day-to-day experience after 2 major surgeries: lower limb total major joint arthroplasty (TJA) and cesarean delivery (CD). Fifty-five TJA patients and 157 CD patients were recruited to complete questionnaires and record their daily pain experiences after surgery. After hospital discharge, patients recorded their pain intensity once daily for 60 days (CD) or twice daily for 2 weeks, once daily for 2 weeks, weekly for 8 weeks, and monthly for 3 months (TJA). Pain scores were modeled using growth curve and Bayesian change-point models. Individual differences in the model fits were examined for evidence of day-to-day differences in pain. A log time model was the simplest model that fit the data, but examination of the residuals revealed high autocorrelation representing misspecification. A change-point model fit the data better and revealed that the form of recovery fundamentally changed between days 10 and 21 after surgery. These data add meaningfully to our understanding of recovery from pain after surgery by extending the period of frequent observations a few days after surgery to a 2-month period. These high time resolution data suggest that there is a typical experience of pain resolution after surgery, but that meaningful subpopulations of experience may exist. They also indicate that a transition occurs within 1 month after surgery from 1 pattern of change in pain over time to another.
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影响因子：
7.4
作者：
Johansen, Aslak;Romundstad, Luis;Stubhaug, Audun
通讯作者：
Stubhaug, Audun
影响因子：
4
作者：
Chapman, C. Richard;Donaldson, Gary W.;Bradshaw, David H.
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Bradshaw, David H.
影响因子：
7.4
作者：
Kannampallil, Thomas;Galanter, William L.;Lambert, Bruce L.
通讯作者：
Lambert, Bruce L.
影响因子：
7.4
作者：
Romundstad, Luis;Breivik, Harald;Stubhaug, Audun
通讯作者：
Stubhaug, Audun
影响因子：
17.1
作者：
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通讯作者：
Nolan GP