[Elevated postoperative pain levels following orthopedic surgery. Depression as a strong predictor].
The aim of this study was to examine whether depression is a strong predictor of elevated postoperative pain levels following orthopedic surgery and whether the implementation of standardized pain management is more beneficial for patients with depression. We performed a non-randomized, prospective study with two different groups of patients who underwent orthopedic surgery. Group 1 (n=249) received non-standardized pain therapy whereas group 2 (n = 243) was treated with a standardized pain management concept. Effects of the treatment were monitored with a VAS-based pain assessment protocol. Depression was measured preoperatively with the self-reported Patient Health Questionnaire (PHQ-9). Patients with the probable diagnosis of a current episode of major depression showed significantly higher postoperative pain than patients without a depressive episode. On the other hand, patients with depression benefited from the implementation of standardized pain management. Our data suggest a predictive value of depression for severe postoperative pain. Patients with depression benefited from standardized postoperative pain therapy, but were still suffering from significantly higher postoperative pain.
Orthopädische Klinik König-Ludwig-Haus, Universität Würzburg, Brettreichstr. 11, 97074, Würzburg. s-goebel.klh@mail.uni-wuerzburg.de
S
S
Goebel
B
B
Baumann
A
A
Steinert
S
S
Reppenhagen
H
H
Faller
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019091:Critical Pathways / Q000592:standards; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000523:psychology*; D010147:Pain Measurement / Q000187:drug effects / Q000523:psychology / Q000592:standards; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D010555:Personality Inventory; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D000700:Analgesics; D000701:Analgesics, Opioid