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The possible link between preoperative pain sensitivity and postoperative pain alongwith analgesic requirements for patients undertaking primary total knee arthroplasty (TKA) has been determined in this prospective study.
As depicted from this prospective study, the patients with
low pain threshold (low algometer scores) have greater analgesic requirements
after operation, had lengthier time to accomplish optimum range of movements
and independent ambulation . Therefore, a proactive method is crucial for
superior pain relief and a congenial experience following surgery in these patients.
The possible link between preoperative pain sensitivity and postoperative pain alongwith analgesic requirements for patients undertaking primary total knee arthroplasty (TKA) has been determined in this prospective study.
The pain sensitivity of 178 patients (mean age 64.13 years;
69.1% females ) undergoing primary TKA was examined before the operation via a
digital algometer. Patients described the VAS (visual analog scale) score at 3 occurrences
of needle prick (phlebotomy, glucometer blood glucose, intradermal antibiotic
test dose), through the range of movements and accomplished the DASS
(Depression, Anxiety, Stress Scale) score. On day 0 to 4, the postoperative VAS
score, analgesic prerequisite, and physiotherapy milestones were noted in all of
these patients.
As found, women had lower mean algometry values (56.12 ± SD12.77) than the men (71.09 ± SD18.78) (p<0.001). An elevated DASS associated with lower algometry values (p<0.001). At day 0, i.e. at the day of the surgery, postoperative VAS score was 2.54 ± 0.59 which raised to 3.27 ± 0.69 on day 1 following mobilization (p<0.001) and decreased to 1.67 ± 0 .62 on day 4 as shown in the following figure:
A low algometer score was linked with higher
postoperative VAS score (p<0.05), increased analgesic requirement, and
opioid use, delay in achieving an ideal range of movements and independent
ambulation (p<0.001).
Preoperative assessment of pain sensitivity foretells the postoperative
analgesic requirements and recovery duration. Preoperative counselling should
be done in patients with a less pain threshold and have
a better titration of analgesics perioperatively and extended physiotherapy.
The Journal of Arthroplasty
Assessing Preoperative Pain Sensitivity Predicts the Postoperative Analgesic Requirement and Recovery After Total Knee Arthroplasty. A Prospective Study Of 178 Patients.
Dhanasekara RajaPalanisami et al.
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