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

Luna, Iben Engelund; Kehlet, Henrik; Petersen, Morten Aa.; Aasvang, Eske Kvanner

doi:10.1111/aas.12899

Cited by 28 publications

(72 citation statements)

References 47 publications

(67 reference statements)

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“…Total hip and knee arthroplasties are associated with considerable pain between the sixth and 24th post-operative hour [1][2][3]. The surgical incision, as a mechanical factor, affects the nociceptor, initiates the pain process, and triggers numerous inflammatory mediators [1,4,5]. The Enhanced Recovery After Surgery (ERAS) with the method multimodal analgesia accelerates the patient's returning to full activity [4][5][6][7][8][9][10] and limits the complications and time of hospitalization [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Gądek

Liszka

Zając

2020

International Orthopaedics (SICOT)

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Purpose The aim of the study was to assess whether administration of a single dose of methylprednisolone in the group patients above 65 years of age will be effective in complex analgesic management after total hip arthroplasty (THA). Methods Seventy-seven patients above 65 years old were double-blind randomized into two: the study and controls groups. Pre-operatively, the study group received as a single dose of 125 mg intravenous methylprednisolone, while the others saline solution as placebo. Peri-operatively, all the patients were administered opioid and nonopioid analgesic agents. We measured the levels of inflammatory markers (leukocytosis, C-reactive protein—CRP), pain intensity level (visual analog scale—VAS; numerical rating scale—NRS), the life parameters, and noted complications. Results Following administration of methylprednisolone were significantly lower levels of CRP on all the four post-operative days; leukocytosis on the second day; the VAS/NRS score at rest after six, 12, and 18 hours post-operatively, diminished the dose of parenteral opioid preparations (oxycodone hydrochloride), the duration of analgesia by peripheral nerve block was significantly higher as compared with the placebo group (p < 0.000001). No infectious complications were noted; there was one patient who developed post-operative delirium. Conclusion A single dose of methylprednisolone significantly reduces the level of post-operative pain at rest on the day of THA in the group patients above 65 years of age, decreases the dose of opioid analgesic agents, and significantly decreases the level of inflammatory markers, without infectious processes.

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Section: Introductionmentioning

confidence: 99%

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Gądek

Liszka

Zając

2020

International Orthopaedics (SICOT)

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“…In the present study, we certified that FM pain perception is an objective widespread chronic pain status where pain is the primary symptom and FM pathogenesis derives from a characteristic morphological modulation of the endogenous antinociceptive pathway. To demonstrate this, we chose OA as a chronic pain control group, considering our previous research on osteoarthritic pain [54] and its well-described nociceptive pain due to degenerative osteoarthritis status [57,58], and compared immunophenotype analysis of FM and OA patients with a pain-free negative control group.…”

Section: Discussionmentioning

confidence: 99%

Identification of MOR-Positive B Cell as Possible Innovative Biomarker (Mu Lympho-Marker) for Chronic Pain Diagnosis in Patients with Fibromyalgia and Osteoarthritis Diseases

Raffaeli

Malafoglia

Bonci

et al. 2020

IJMS

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Fibromyalgia (FM) diagnosis follows the American College of Rheumatology (ACR) criteria, based on clinical evaluation and written questionnaires without any objective diagnostic tool. The lack of specific biomarkers is a tragic aspect for FM and chronic pain diseases in general. Interestingly, the endogenous opioid system is close to the immune one because of the expression of opioid receptors on lymphocytes membrane. Here we analyzed the role of the Mu opioid receptor on B lymphocytes as a specific biomarker for FM and osteoarthritis (OA) patients. We enrolled three groups of females: FM patients, OA patients (chronic pain control group) and healthy subjects (pain-free negative control group). We collected blood samples to apply immunophenotyping analysis. Written tests were administrated for psychological analysis. Data were statistically analyzed. Final results showed that the percentage of Mu-positive B cells were statistically lower in FM and OA patients than in pain-free subjects. A low expression of Mu-positive B cell was not associated with the psychological characteristics investigated. In conclusion, here we propose the percentage of Mu-positive B cells as a biological marker for an objective diagnosis of chronic pain suffering patients, also contributing to the legitimacy of FM as a truly painful disease.

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“…Following this initial review, 46 full-texts were assessed for eligibility of which 20 manuscripts were excluded for at least one of the following reasons: non-significant findings (n = 6) 1,10,48,56,58,63 , the analyses/results were not relevant to review hypotheses (n = 6) 6,9,20,35,42,90 , and the critical test statistic was not reported, could not be computed based on reported data, and could not be obtained after contact with the author (n = 3) 3,18,86 (see Figure 1). The latter criterion included studies reporting pvalue ranges (e.g.…”

Section: Study Selection and Search Criteriamentioning

confidence: 99%

Investigating the True Effect of Psychological Variables Measured Prior to Arthroplastic Surgery on Postsurgical Outcomes: A P-Curve Analysis

Niederstrasser

Cook

2021

The Journal of Pain

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

Cited by 28 publications

References 47 publications

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Identification of MOR-Positive B Cell as Possible Innovative Biomarker (Mu Lympho-Marker) for Chronic Pain Diagnosis in Patients with Fibromyalgia and Osteoarthritis Diseases

Investigating the True Effect of Psychological Variables Measured Prior to Arthroplastic Surgery on Postsurgical Outcomes: A P-Curve Analysis

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