Clinical, nociceptive and psychological profiling to predict acute pain after total knee arthroplasty

Acta Anaesthesiologica Scandinavica
Iben Engelund LunaEske Kvanner Aasvang

Abstract

Pre-operative identification of high-pain responders for acute pain after total knee arthroplasty (TKA) could lead to targeted analgesic trials and individualized analgesic strategies to improve recovery and potentially reduce the risk of persistent post-surgical pain. The aim of this study was to use simple clinical tests and questionnaires to identify predictive nociceptive and psychological factors for acute post-TKA pain. Sixty consecutive TKA patients were included in a prospective descriptive study of pain during a 5-m walk-test 24 h post-operatively as the primary outcome. Predictive variables collected prior to surgery included demographics, nociceptive testing (pressure pain threshold (PPT), cold pressor tolerance, electrical pain threshold and tolerance) and psychological profile (pain catastrophizing scale (PCS) and hospital anxiety and depression scale). The prediction of acute post-TKA pain was assessed by univariate analysis, logistic regressions and ROC curves. Reduced PPT on the arm and increased PCS were predictive variables for moderate/severe post-TKA pain 24 h after surgery (P = 0.007 and P = 0.026, respectively, R-squared 0.21) in the logistic regression model. Odds ratios were 0.67 for a 50 kPa increased P...Continue Reading

References

Jan 27, 1990·BMJ : British Medical Journal·J N MatthewsP Royston
Jun 1, 1983·Acta Psychiatrica Scandinavica·A S Zigmond, R P Snaith
Dec 4, 2003·Clinical Orthopaedics and Related Research·Victoria A BranderTimothy Houle
May 27, 2004·The Journal of Pain : Official Journal of the American Pain Society·Laura A MitchellEric E Brodie
Dec 13, 2005·Scandinavian Journal of Gastroenterology·Thue BisgaardHenrik Kehlet
May 16, 2006·Lancet·Henrik KehletClifford J Woolf
Oct 10, 2006·The Journal of Arthroplasty·David W Elson, Ivan J Brenkel
Dec 22, 2006·American Journal of Epidemiology·Eric Vittinghoff, Charles E McCulloch
Feb 8, 2008·The Journal of Bone and Joint Surgery. British Volume·H LundbladK A Jansson
Jul 25, 2008·The Journal of Pain : Official Journal of the American Pain Society·Eske Kvanner AasvangHenrik Kehlet
Aug 6, 2008·Clinical Orthopaedics and Related Research·Jasvinder A SinghDavid Lewallen
May 6, 2009·Anaesthesia·L Ø AndersenH Kehlet
Jun 23, 2009·European Journal of Pain : EJP·Anouk StreffFernand Anton
Jul 9, 2009·Clinical Orthopaedics and Related Research·Daniel L RiddleXiangrong Kong
Oct 21, 2009·Journal of Rehabilitation Medicine·Ann L PerssonBengt H Sjölund
Mar 18, 2010·Anesthesiology·Eske K AasvangHenrik Kehlet
Sep 14, 2010·American Journal of Surgery·Reenam S KhanThanos Athanasiou
Nov 1, 2011·Seminars in Arthritis and Rheumatism·Maaike M VissersMax Reijman
Nov 29, 2011·Rheumatology·Vikki WyldePaul Dieppe
Jan 26, 2012·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·E Carlos Rodriguez-Merchan
Feb 6, 2013·The Journal of Pain : Official Journal of the American Pain Society·R Norman HardenStephen Bruehl
Jun 26, 2013·British Journal of Anaesthesia·A Ellis, D L H Bennett
Aug 27, 2013·Osteoarthritis and Cartilage·E Y ChanM Fransen
Nov 10, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Irina GrosuEmmanuel Thienpont
Mar 19, 2014·The Journal of Arthroplasty·Nicolas O NoiseuxBarbara A Rakel
May 8, 2014·Journal of Pain & Palliative Care Pharmacotherapy·Axel Sauter, Harald Breivik
Jun 19, 2014·British Journal of Anaesthesia·L Ø Andersen, H Kehlet

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Citations

Jun 22, 2018·Regional Anesthesia and Pain Medicine·Jose L ZeballosJames P Rathmell
Oct 1, 2018·Pain Practice : the Official Journal of World Institute of Pain·Anna K M Persson, Jonas Åkeson
Jan 8, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Dennis Boye LarsenKristian Kjær Petersen
Oct 26, 2020·The Journal of Pain : Official Journal of the American Pain Society·Nils Georg Niederstrasser, Stephanie Cook
Mar 31, 2019·Journal of Clinical Anesthesia·Hussein Nasser AwadaEske Kvanner Aasvang

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