A good beginning makes a good ending: association between acute pain trajectory and chronic postsurgical pain
A good beginning makes a good ending: association between acute pain trajectory and chronic postsurgical pain
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一个好的开始就有一个好的结局：急性疼痛轨迹与慢性术后疼痛之间的关联
DOI：
10.1007/s00540-018-2570-0
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发表时间：
2018
影响因子：
2.8
通讯作者：
Amaya Fumimasa
中科院分区：
文献类型：
--
作者：
Yamaguchi Yosuke;Oh-hashi Kentaro;Matsuoka Yutaka;Takemura Hitomi;Yamakita Shunsuke;Matsuda Megumi;Sawa Teiji;Amaya Fumimasa;Amaya Fumimasa
手术后持续较长时间的慢性疼痛是疼痛医学领域的新兴医学问题之一。慢性术后疼痛的存在与健康相关的生活质量差、医疗费用增加和负面心理影响有关[1]。在美国，5%的阿片类药物初治患者在手术后成为长期阿片类药物使用者[2]。慢性术后疼痛最初定义为疼痛持续至少2个月[3]。然而，有争议的是，2个月的时间可能太短，无法完全排除“外科手术的功能结果”[4]。根据国际疾病分类第11版（ICD-11），最近开发的慢性疼痛分类将慢性术后疼痛定义为术后持续至少3个月的疼痛[5]。根据这一定义，慢性术后疼痛的发生率估计为10-50%[6]。尽管其发生频率因手术类型而异，但组织损伤程度或神经损伤的存在并不总是与慢性术后疼痛的发生率相关[7，8]。慢性术后疼痛的高患病率是一个全球现象。Sugiyama等人在日本进行了一项多中心调查，以研究全膝关节置换术（TKA）和肺癌手术后慢性术后疼痛的患病率，并得出结论，TKA和肺部手术后3个月的慢性疼痛患病率分别为49%和18%[9]。慢性术后疼痛具有基于导致慢性疼痛状况的事件的独特特征。大多数接受择期手术的患者有机会接受预防性镇痛干预。因此，已经进行了几项研究，以确定围手术期
Chronic pain continuing for a long time after surgery is one of the emerging medical problems in the field of pain medicine. The presence of chronic postsurgical pain is associated with poor health-related quality of life, increased medical costs and negative psychological effects [1]. In the United States, 5% of opioid naive patients become long-term opioid users after surgery [2].Chronic postsurgical pain was initially defined as pain continuing for at least 2 months [3]. However, it was debated that 2 months might be too short a period to completely exclude the “functional results of the surgical procedure”[4]. The more recently developed classification of chronic pain according to the International Classification of Diseases 11th Revision (ICD-11) defines chronic postsurgical pain as pain that persists for at least 3 months after the surgery [5]. Based on this definition, the incidence of chronic postsurgical pain was estimated as 10–50%[6]. Although its frequency varies depending on the type of surgery, the degree of tissue injury or presence of nerve injury does not always correlate with the incidence of chronic postsurgical pain [7, 8]. The high prevalence of chronic postsurgical pain is a global phenomenon. Sugiyama et al. conducted a multicenter survey in Japan to investigate the prevalence of chronic postsurgical pain after total knee arthroplasty (TKA) and lung cancer surgery, and concluded that chronic pain prevalence was 49% and 18% at 3 months after TKA and lung surgery, respectively [9]. Chronic postsurgical pain has unique characteristics based on the event that leads to the chronic pain condition. Most patients undergoing elective surgery have a chance to receive preventive analgesic intervention. Consequently, several studies have been conducted to determine perioperative