Acute postoperative pain following hospital discharge after total knee arthroplasty

被引:106
作者
Chan, E. Y. [1 ]
Blyth, F. M. [2 ]
Nairn, L. [1 ]
Fransen, M. [1 ]
机构
[1] Univ Sydney, Fac Hlth Sci, Lidcombe, NSW 1825, Australia
[2] Univ Sydney, Sydney Sch Publ Hlth, Lidcombe, NSW 1825, Australia
关键词
Acute pain; Pain management; Analgesics; Non-pharmacological methods; Knee arthroplasty; Surveys; TOTAL HIP; POSTSURGICAL PAIN; PHYSICAL-ACTIVITY; OLDER-ADULTS; REPLACEMENT; MANAGEMENT; MOBILIZATION; REDUCE; WOMAC; STAY;
D O I
10.1016/j.joca.2013.06.011
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: The increasingly shorter hospitalization following total knee arthroplasty (TKA) requires patients to assume earlier responsibility to self-manage their pain. Poorly managed acute pain increases the risk of persistent pain, reduces quality of life and increases unnecessary healthcare utilization. This study aims to examine post-discharge pain intensity, pain management behaviors and potential barriers to optimal self-management of pain. Design: We administered a questionnaire at 2 weeks after discharge to 174 patients undergoing TKA in 10 Australian hospitals. Participants rated pain expectation and severity, use of analgesics and non-pharmacological methods, side-effects, walking and exercise times, perceptions of analgesics, adequacy of pain management information provided and satisfaction with pain relief. Results: Of 171 (98%) participants who completed the questionnaire, 88 (52%) reported that the worst pain period occurred during the first 2 weeks at home. During the first 2 weeks at home, the average pain was 'severe/extreme' for 40 (23%) participants and 92 (54%) experienced severe pain at least some of the time. Many participants sought further medical help for their pain. Adequate information on analgesics and non-pharmacological methods for pain relief were reported by only 73% and 47%, respectively. Approximately 20% had negative perceptions about analgesic use. Higher pain severity was associated with lower satisfaction and less time spent walking daily. Conclusions: Effective pain relief after hospital discharge following TKA is a challenge. Many participants reported significant pain, sought further medical help for pain relief and had inadequate information at discharge to effectively self-manage their postoperative knee pain. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1257 / 1263
页数:7
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