Total diz artroplastisi uygulanan hastalarda ameliyat öncesi ve sonrasındaki uyku kalitesinin değerlendirilmesi

Yıl 2014, Cilt: 48 Sayı: 1, 50 - 54, 17.03.2014

Mehmet Serhan Er Elif Cihan Altinel Levent Altinel Recep Abdullah Erten Mehmet Eroglu

Öz

Amaç: Bu çalışmanın amacı total diz artroplastisi uygulanan hastaların ameliyat öncesi ve sonrasındaki uyku kalitelerini karşılaştırmak ve total diz artroplastisinin uyku kalitesine etkisini incelemekti.
Çalışma planı: Primer osteoartrit tanısı konulmuş ve total diz artroplastisi (TDA) uygulanmış 10’u erkek, 32’si kadın toplam 42 hasta çalışmaya alındı. Pittsburgh Uyku Kalitesi İndeksi (PSQI) anketi ve 100 mm’lik bir görsel ağrı Visual Analog Skalası (VAS) ile hastaların ameliyattan 1 gün önceki ve 3 ay sonraki durumları karşılaştırıldı.
Bulgular: Ameliyat öncesi PSQI skoru ortalama 9 olarak bulundu. Hastaların %97.6’sında VAS skoru azalırken %78.6’sında toplam uyku kalitesinin arttığı görüldü. Ayrıca hastaların %85.7’sinde ameliyat öncesi döneme göre ağrıya bağlı uyku bölünmesinin daha nadir olduğu saptandı. VAS ve PSQI değerlerinde ameliyat sonrasında düzelme olsa da bu iki parametre arasında istatistiksel olarak anlamlı bir korelasyon saptanmadı (p>0.05).
Çıkarımlar: Çalışmamız TDA’nın hem ağrıyı giderdiğini ve hem de uyku kalitesini düzelttiğini gösterdi. Sonuçlarımız uyku kalitesindeki düzelmenin ağrıdan bağımsız olduğunu telkin etmektedir.

Anahtar Kelimeler

Uyku kalitesi; Pittsburgh uyku kalitesi indeksi (PSQI); total diz artroplastisi.

An assessment of sleep quality in patients undergoing total knee arthroplasty before and after surgery

Öz

Objective: The aim of this study was to compare the sleep quality of patients who underwent total knee arthroplasty before and after the surgery and analyze the effect of total knee arthroplasty on sleep quality.
Methods: The study included 42 patients (32 females, 10 males) who underwent total knee arthroplasty for primary knee osteoarthritis. For each patient the preoperative 1 day and postoperative 3 months results of Pittsburgh Sleep Quality Index (PSQI) and 100–mm visual analogue scale (VAS) were compared.
Results: The preoperative mean PSQI was 9. VAS score decreased in 97.6% of the patients, while sleep quality increased in 78.6%. 85.7% of the patients reported to have less episodes of pain related sleep disturbances. While both the PSQI and VAS improved after the surgery, there was no correlation between the parameters (p>0.05).
Conclusion: Our results suggested that total knee arthroplasty surgery relieves pain and improves sleep quality. The improvement in sleep quality does not appear to be related to pain relief.

Anahtar Kelimeler

Sleep quality, Pittsburgh sleep quality index, total knee arthroplasty

Kaynakça

• Sarzi-Puttini P, Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, et al. Osteoarthritis: an overview of the disease and its treatment strategies. Semin Arthritis Rheum 2005;35(1 Suppl 1):1-10. CrossRef
• Rissanen P, Aro S, Sintonen H, Slätis P, Paavolainen P. Quality of life and functional ability in hip and knee re- placements: a prospective study. Qual Life Res 1996;5:56- 64. CrossRef
• Foley D, Ancoli-Israel S, Britz P, Walsh J. Sleep distur- bances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res 2004;56:497-502. CrossRef
• McCurry SM, Von Korff M, Vitiello MV, Saunders K, Balderson BH, Moore AL, et al. Frequency of comorbid insomnia, pain, and depression in older adults with osteo- arthritis: predictors of enrollment in a randomized treat- ment trial. J Psychosom Res 2011;71:296-9. CrossRef
• Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the lit- erature. J Bone Joint Surg Am 2004;86:963-74.
• Fielden JM, Gander PH, Horne JG, Lewer BM, Green RM, Devane PA. An assessment of sleep disturbance in patients before and after total hip arthroplasty. J Arthro- plasty 2003;18:371-6. CrossRef
• Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new in- strument for psychiatric practice and research. Psychiatry Res 1989;28:193-213. CrossRef
• Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG, et al. A comparison of outcomes in os- teoarthritis patients undergoing total hip and knee replace- ment surgery. Osteoarthritis Cartilage 2001;9:137-46.
• Murphy SL, Lyden AK, Phillips K, Clauw DJ, Williams DA. Subgroups of older adults with osteoarthritis based upon differing comorbid symptom presentations and po- tential underlying pain mechanisms. Arthritis Res Ther 2011;13:R135. CrossRef
• Wiklund I, Romanus B. A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint. J Bone Joint Surg Am 1991;73:765-9.
• Karthik N, Kulkarni GB, Taly AB, Rao S, Sinha S. Sleep disturbances in ‘migraine without aura’-a questionnaire based study. J Neurol Sci 2012;321:73-6. CrossRef
• Fujiwara Y, Arakawa T, Fass R. Gastroesophageal re- flux disease and sleep disturbances. J Gastroenterol 2012;47:760-9. CrossRef
• Backhaus J, Junghanns K, Broocks A, Riemann D, Hoha- gen F. Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 2002;53:737-40. CrossRef
• Carpenter JS, Andrykowski MA. Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 1998;45:5-13. CrossRef