V Wylde1, J Rooker, L Halliday, A Blom. 1. Musculoskeletal Research Unit, University of Bristol, Avon Orthopaedic Centre (lower level), Southmead Hospital, BS10 5NB, Bristol, United Kingdom. V.Wylde@bristol.ac.uk
Abstract
INTRODUCTION: The management of acute postoperative pain poses a significant challenge in surgical specialities. Despite the prevalence and impact of acute postoperative pain, there is a paucity of published data regarding its occurrence and sensory qualities after joint replacement. HYPOTHESIS: That a proportion of patients would experience severe acute postoperative pain at rest after total hip replacement (THR) and total knee replacement (TKR). MATERIALS AND METHODS: Pain was assessed preoperatively, and then five times daily for the first three postoperative days in 105 THR and TKR patients. Pain severity was assessed using a pain Visual Analogue Scale and the sensory qualities of pain were assessed using the pain descriptors from the Short-Form McGill Pain Questionnaire. RESULTS: Median acute pain scores peaked on the first postoperative day, with 58% of TKR patients and 47% of THR patients reporting moderate-severe pain. Preoperative pain was most frequently described as aching, stabbing and sharp, whereas acute postoperative pain was described as aching, heavy and tender. Night pain disturbed between 44-57% of TKR patients and 21-52% of THR patients on postoperative nights 1-3. DISCUSSION: These findings demonstrate that acute postoperative pain at rest after joint replacement, particularly TKR, is poorly managed, although it does not reach the severity of preoperative pain. LEVEL OF EVIDENCE: Level IV (observational cohort study).
INTRODUCTION: The management of acute postoperative pain poses a significant challenge in surgical specialities. Despite the prevalence and impact of acute postoperative pain, there is a paucity of published data regarding its occurrence and sensory qualities after joint replacement. HYPOTHESIS: That a proportion of patients would experience severe acute postoperative pain at rest after total hip replacement (THR) and total knee replacement (TKR). MATERIALS AND METHODS:Pain was assessed preoperatively, and then five times daily for the first three postoperative days in 105 THR and TKR patients. Pain severity was assessed using a pain Visual Analogue Scale and the sensory qualities of pain were assessed using the pain descriptors from the Short-Form McGill Pain Questionnaire. RESULTS: Median acute pain scores peaked on the first postoperative day, with 58% of TKR patients and 47% of THR patients reporting moderate-severe pain. Preoperative pain was most frequently described as aching, stabbing and sharp, whereas acute postoperative pain was described as aching, heavy and tender. Night pain disturbed between 44-57% of TKR patients and 21-52% of THR patients on postoperative nights 1-3. DISCUSSION: These findings demonstrate that acute postoperative pain at rest after joint replacement, particularly TKR, is poorly managed, although it does not reach the severity of preoperative pain. LEVEL OF EVIDENCE: Level IV (observational cohort study).
Authors: Patrick Tighe; Chester C Buckenmaier; Andre P Boezaart; Daniel B Carr; Laura L Clark; Andrew A Herring; Michael Kent; Sean Mackey; Edward R Mariano; Rosemary C Polomano; Gary M Reisfield Journal: Pain Med Date: 2015-06-10 Impact factor: 3.750