TY - JOUR
T1 - Postoperative pain after hip fracture is procedure specific
AU - Foss, Nicolai
AU - Kristensen, Morten Tange
AU - Palm, H
AU - Kehlet, H
AU - Foss, Nicolai Bang
AU - Kristensen, Morten Tange
AU - Palm, Henrik
AU - Kehlet, Henrik
N1 - Keywords: Adult; Aged; Aged, 80 and over; Analgesia, Epidural; Arthroplasty, Replacement, Hip; Bone Nails; Bone Screws; Female; Fracture Fixation, Internal; Fracture Fixation, Intramedullary; Hip Fractures; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Physical Therapy Modalities; Prospective Studies; Walking
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Hip fracture patients experience high pain levels during postoperative rehabilitation. The role of surgical technique on postoperative pain has not been evaluated previously. METHODS: One hundred and seventeen hip fracture patients were included in a descriptive prospective study. All patients received continuous epidural analgesia and were treated according to a standardized perioperative rehabilitation programme. Resting pain, pain on hip flexion, and walking were measured during daily physiotherapy sessions on a verbal five-point rating scale during the first four postoperative days. Patients were stratified into four groups according to surgical procedure: screws or pins, arthroplasty, dynamic hip screw (DHS), and intra-medullary hip screw (IMHS). RESULTS: Cumulated pain levels were significantly different between surgical procedures both for hip flexion (P=0.002) and for walking (P=0.02) with highest dynamic pain levels for patients who had either DHSs or IMHSs compared with arthroplasty or parallel implants. There were significant negative correlations between ambulatory capacity assessed by the cumulated ambulation score and both the dynamic cumulated pain scores on hip flexion (r=-0.43, P<0.001) and walking (r=-0.36, P=0.004). CONCLUSIONS: Postoperative pain levels after surgery for hip fracture are dependent on the surgical procedure, which should be taken into account in future studies of analgesia and rehabilitation.
AB - BACKGROUND: Hip fracture patients experience high pain levels during postoperative rehabilitation. The role of surgical technique on postoperative pain has not been evaluated previously. METHODS: One hundred and seventeen hip fracture patients were included in a descriptive prospective study. All patients received continuous epidural analgesia and were treated according to a standardized perioperative rehabilitation programme. Resting pain, pain on hip flexion, and walking were measured during daily physiotherapy sessions on a verbal five-point rating scale during the first four postoperative days. Patients were stratified into four groups according to surgical procedure: screws or pins, arthroplasty, dynamic hip screw (DHS), and intra-medullary hip screw (IMHS). RESULTS: Cumulated pain levels were significantly different between surgical procedures both for hip flexion (P=0.002) and for walking (P=0.02) with highest dynamic pain levels for patients who had either DHSs or IMHSs compared with arthroplasty or parallel implants. There were significant negative correlations between ambulatory capacity assessed by the cumulated ambulation score and both the dynamic cumulated pain scores on hip flexion (r=-0.43, P<0.001) and walking (r=-0.36, P=0.004). CONCLUSIONS: Postoperative pain levels after surgery for hip fracture are dependent on the surgical procedure, which should be taken into account in future studies of analgesia and rehabilitation.
U2 - 10.1093/bja/aen345
DO - 10.1093/bja/aen345
M3 - Journal article
C2 - 19059921
SN - 0007-0912
VL - 102
SP - 111
EP - 116
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 1
ER -