肩袖损伤患者术前焦虑状况与肩关节镜术后疼痛的相关性分析

Correlation analysis between preoperative anxiety and postoperative pain in patients after arthroscopic rotator cuff repair

目的分析肩袖损伤行关节镜下肩袖修复手术的患者术前各因素对术后疼痛的影响。方法本研究回顾性分析了2018年1月至2019年12月本科室收治的肩袖损伤患者的基本资料,所有患者术前进行视觉模拟评分(visual analogue scale,VAS)、美国肩肘外科协会评分(American shoulder and elbow surgeons,ASES)、焦虑自评量表(self-rating anxiety scale,SAS)的测定,采用多元线性回归分析术后疼痛的影响因素。结果纳入研究的患者共63例,术前SAS评分的平均值为(31.39±6.45)分;术后当天静息痛VAS评分平均(1.26±1.17)分,术后当天活动痛VAS评分平均(2.82±1.60)分;术后第1天静息痛VAS评分平均(1.11±1.18)分,术后第1天活动痛VAS评分平均(2.71±1.01)分。多元线性回归分析结果显示术前SAS评分是术后当天静息痛、术后当天活动痛、术后第1天活动痛的独立影响因素(P<0.05)。镇痛方式是术后第1天活动痛的独立影响因素(P<0.05)。结论肩袖损伤患者术前焦虑状态会影响患者术后的疼痛反应,焦虑状态越严重的患者,术后疼痛反应更为强烈。术前关注患者焦虑状态的评估和干预有助于减轻患者术后的疼痛反应,加快患者术后康复进程,提升患者的生活质量。

Background Rotator cuff repair surgery is often accompanied by pain of various degrees and duration.Severe postoperative pain can make it difficult for patient to fall asleep or even to lie down,which seriously affects the patient's satisfaction with the treatment.Previous studies have suggested that patients with chronic pain often have an anxiety state which aggravates the pain perception.Surgical patients all have different degrees of pain after surgery.Perioperative analgesia has always been the focus and hot spot,and the occurrence and severity of pain are affected by many factors,such as gender,surgical methods,emotional state,etc.Thus,assessing the factors that influence pain is the focus of the development of personalized analgesia programs.Objective To analyze the influence of preoperative factors on postoperative pain in patients after arthroscopic rotator cuff repair.Methods In this study,the patients with rotator cuff injuries admitted to the department of and orthopedics from January 2018 to December 2019 were included.Each patient was evaluated by visual analogue scale(VAS),American Shoulder and elbow surgeons(ASES),and self-rating anxiety scale(SAS)before surgery,and multiple linear regression was used to analyze the influencing factors of postoperative pain.Results A total of 63 patients were included in the study.The average preoperative SAS score was(31.39±6.45)points.The average VAS scores of rest pain and motion pain were(1.26±1.17)points and(2.82±1.60)points respectively on the day after surgery.The average VAS scores of rest pain and motion pain were(1.11±1.18)points and(2.71±1.01)points respectively on the 1st day after surgery.The results of multiple linear regression analysis showed that preoperative SAS anxiety score was the independent influencing factor of rest pain and motion pain on the day after the operation,and motion pain on the 1st day after surgery(P0.05).In addition,analgesia method was also an independent factor affecting the motion pain on the 1st day after the operation(P0.05).Conclusion The preoperative anxiety state of patients with rotator cuff injury affects the postoperative pain response.The more severe anxiety state of patient was,the more intense the postoperative pain response would be.Preoperative assessment and intervention of patients’anxiety state can help to diminish postoperative pain response,accelerate postoperative rehabilitation,and improve the quality of life.