title: Surgical predictors of acute postoperative pain after hip arthroscopy.
abstract: BACKGROUND
  Pain following hip arthroscopy is highly variable and can be severe. Little published data exists demonstrating reliable predictors of significant pain after hip arthroscopy. The aim of this study was to identify influence of intraoperative factors (arthroscopic fluid infusion pressure, operative type) on the severity of postoperative pain.
  
  
  METHODS
  A retrospective review of 131 patients who had received a variety of arthroscopic hip interventions was performed. A standardized anaesthetic technique was used on all patients and postoperative pain was analysed using recovery pain severity outcomes and analgesic use. A multivariate logistic regression analysis was performed on intraoperative factors including patient age, sex and BMI, arthroscopic infusion pressures (40 vs 80 mm Hg), amount of fluid used, length of surgery and types of arthroscopic interventions performed. Thirty six patients were also prospectively examined to determine arthroscopic fluid infusion rates for 40 and 80 mm Hg infusion pressures.
  
  
  RESULTS
  Use of a higher infusion pressure of 80 mm Hg was strongly associated with all pain severity endpoints (OR 2.8 - 8.2). Other significant factors included hip arthroscopy that involved femoral chondro-ostectomy (OR 5.8) and labral repair (OR 7.5). Length of surgery and total amount of infusion fluid used were not associated with increased pain.
  
  
  CONCLUSIONS
  80 mm Hg arthroscopic infusion pressures, femoral chondro-osteoectomy and labral repair are strongly associated with significant postoperative pain, whereas intraoperative infusion volumes or surgical duration are not. Identification of these predictors in individual patients may guide clinical practice regarding the choice of more invasive regional analgesia options. The use of 40 mm Hg arthroscopic infusion pressures will assist in reducing postoperative pain.
authors.affiliation: Department of Anaesthesia, The Austin Hospital, 145 Studley Rd, Heidelberg, VIC, 3084, Australia. Drchongtan@gmail.com.|The University of Melbourne, Melbourne, VIC, 3010, Australia. Drchongtan@gmail.com.
authors.forename: Chong Oon
authors.initials: CO
authors.lastname: Tan
authors.affiliation: Department of Surgery, St. Vincent's Hospital Melbourne, Victoria Pde, Fitzroy, VIC, Australia. yewming.chong@svhm.org.au.
authors.forename: Yew Ming
authors.initials: YM
authors.lastname: Chong
authors.affiliation: Department of Orthopaedics, Western Health, Gordon St, Footscray, VIC, 3011, Australia. office@sosclinic.com.au.
authors.forename: Phong
authors.initials: P
authors.lastname: Tran
authors.affiliation: Department of Anaesthesia, The Austin Hospital, 145 Studley Rd, Heidelberg, VIC, 3084, Australia. Laurence.Weinberg@austin.org.au.|The University of Melbourne, Melbourne, VIC, 3010, Australia. Laurence.Weinberg@austin.org.au.
authors.forename: Laurence
authors.initials: L
authors.lastname: Weinberg
authors.affiliation: Department of Anaesthesia, The Austin Hospital, 145 Studley Rd, Heidelberg, VIC, 3084, Australia. William.Howard@austin.org.au.|The University of Melbourne, Melbourne, VIC, 3010, Australia. William.Howard@austin.org.au.
authors.forename: William
authors.initials: W
authors.lastname: Howard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology*; D011312:Pressure; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult