Survey Criteria for Fibromyalgia Independently Predict Increased Postoperative Opioid Consumption after Lower-extremity Joint Arthroplasty
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Open Access
- 1 December 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesiology
- Vol. 119 (6), 1434-1443
- https://doi.org/10.1097/aln.0b013e3182a8eb1f
Abstract
Variance in pain after total knee and hip arthroplasty may be due to a number of procedural and peripheral factors but also, in some individuals, to aberrant central pain processing as is described in conditions like fibromyalgia. To test this hypothesis, the authors conducted a prospective, observational cohort study of patients undergoing lower-extremity joint arthroplasty. Five hundred nineteen patients were preoperatively phenotyped using validated self-reported pain questionnaires, psychological measures, and health information. In addition to being assessed for factors previously found to be associated with poor outcomes in arthroplasty, participants also completed the American College of Rheumatology survey criteria for fibromyalgia. Previous studies have suggested that rather than being “present” or “absent,” features of fibromyalgia as measured by this instrument, occur over a wide continuum. Postoperative pain control was assessed by total postoperative opioid consumption. Preoperatively, patients with higher fibromyalgia survey scores were younger, more likely to be female, taking more opioids, reported higher pain severity, and had a more negative psychological profile. In the multivariate analysis, the fibromyalgia survey score, younger age, preoperative opioid use, knee (vs. hip), pain severity at baseline, and the anesthetic technique were all predictive of increased postoperative opioid consumption. The use of the survey criteria for fibromyalgia led to the finding of distinct phenotypic differences, and the measure was independently predictive of opioid consumption. This self-report measure may provide an additional simple means of predicting postoperative pain outcomes and analgesic requirements. Future studies are needed to determine whether tailored therapies can improve postoperative pain control in this population.This publication has 35 references indexed in Scilit:
- Utilization of Critical Care Services among Patients Undergoing Total Hip and Knee ArthroplastyAnesthesiology, 2012
- Validation of the Fibromyalgia Survey Questionnaire within a Cross-Sectional SurveyPLOS ONE, 2012
- FibromyalgiaCurrent Opinion in Anaesthesiology, 2011
- The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgiaArthritis Research & Therapy, 2011
- Central sensitization: Implications for the diagnosis and treatment of painPain, 2011
- The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom SeverityArthritis Care & Research, 2010
- Understanding Fibromyalgia: Lessons from the Broader Pain Research CommunityThe Journal of Pain, 2009
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studiesJournal of Clinical Epidemiology, 2008
- painDETECT: a new screening questionnaire to identify neuropathic components in patients with back painCurrent Medical Research and Opinion, 2006
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983