THE FACTORS ASSOCIATED WITH SEVERE POSTOPERATIVE PAIN IN PATIENTS WITH TOTAL HIP ARTHROPLASTY

Abstract

Objectives. Determine the risk factors for the development of postoperative pain, particularly those connected with psychological distress and a personality trait.
Patients and Methods. Observational clinical study had case-control design within a cohort of 90 orthopedic patients with a cemented total hip replacement having postoperative pain. Depending on the intensity of postoperative pain based on numerical rating scale (NRS) threshold the patients were divided in experimental (n=44, NRS≥5) and control groups (n=46) (NRS<5). The examinees were post-operatively tested using Hamilton's scales for anxiety and depression symptoms as well as DS-14 test for the identification of D-type personality.
Results. In experimental group there were greater frequencies of female patients (29 vs. 13), and those with anxiety (13 vs. 3) and depression symptoms (11 vs. 2) as well as D-type personality (18 vs. 9) and they had grater intensity of preoperative pain (the mean NRS±standard deviation, 7.2±1.7 vs. 6.0±1.2, p<0.001). The factors associated with development of strong postoperative pain was female gender (Odds Ratio-OR=4.91, 95% confidence intervals-CI 2.01-12.01, p<0.001), type-D personality (2.81, 1.17-7.318, p=0.030), severe anxiety (6.01, 1.58-22.90, p=0.009) and depressive symptoms (7.33, 1.52-35.34, p=0.013) and (2.64, 1.17-5.44, p<0.001).
Conclusion. Introvert patients, with high score of negative affect and social inhibition are at risk of developing severe postoperative pain. Together with this, anxiety and depression are important risk factors.

 

DOI: 10.3944/AOTT.2015.14.0177
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Keywords

• Orthopedics;pain, postoperative;Risk Factors;type D personality;anxiety;depression;female.