Nociceptive Profile and Analgesic use of Patients Submitted to Rotator Cuff Repair Surgery: A Prospective Cohort^[*]

Abstract

Objective This study aimed to evaluate the nociceptive profile and the intake of analgesic drugs of patients submitted to rotator cuff repair surgery. Also, to evaluate the nociceptive thresholds and the integrity of the descending inhibitory system, pain catastrophism and prevalence of nociceptive or neuropathic pain.

Methods Approved by the Ethics Committee of La Salle University (1.325.433/2015). 40 patients (>18 years old) who underwent rotator cuff repair surgery (divided in small and large injuries) were recruited. The used instruments were: Sociodemographic Questionnaire, Functional Pain Scale, Visual Analogue Scale (VAS), Quantitative Sensory Test (QST) and Conditioned Pain Modulation Task (CPM).

Results Patients had a significant difference in pain thresholds QST heat (independent samples t test) and quality of sleep, mood and anxiety (paired t test) in groups preoperative. There was a significant correlation between preoperative CPM and postoperative VAS (Pearson Correlation). It was observed that, in preoperative, 38 patients used analgesics continuously. Besides that, in postoperative, use of opioid drugs was higher in patients with small injury (13 patients) than in those with large injury (9 patients).

Conclusion Therefore, patients with rotator cuff injuries did not present alterations in the descending inhibitory system, but showed alterations in pain thresholds, which may interfere in the postoperative period and still be related to the consumption of analgesics.

Keywords

rotator cuff injury - chronic pain - nociceptive pain

^* Work developed in the Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade La Salle, Canoas, RS, Brasil.

Financial Support

There was no financial support from public, commercial, or non-profit sources.

Publikationsverlauf

Eingereicht: 25. Mai 2020

Angenommen: 16. September 2020

Artikel online veröffentlicht:
31. März 2021

• Referências

• 1 Barros SRF, Lima RNS, Pimentel IT, Silva JR, Bernardino WSS, Ramos DKR. Conhecimentos sobre dor adquiridos nos cursos de ciências em saúde: Uma Revisão Integrativa. Rev Univ Vale Rio Verde 2014; 12 (02) 706-715
• 2 Merskey H, Bogduk N. Classification of Chronic Pain. 2nd ed.. IASP Task Force on Taxonomy, IASP Press; Seattle: 1994. . Part III: Pain Terms, A Current List with Definitions and Notes on Usage;1994: 209-214
• 3 Hylands-White N, Duarte RV, Raphael JH. An overview of treatment approaches for chronic pain management. Rheumatol Int 2017; 37 (01) 29-42
• 4 St John Smith E. Advances in understanding nociception and neuropathic pain. J Neurol 2018; 265 (02) 231-238
• 5 Caixeta LR, Stival MM, Lima LR. Dor aguda: julgamento clínico de enfermagem no pós operatório de cirurgia cardíaca. Rev Min Enfermagem 2012; 16 (03) 400-409
• 6 Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol 2016; 33 (03) 160-171
• 7 Kehlet H. Postoperative pain, analgesia, and recovery-bedfellows that cannot be ignored. Pain 2018; 159 (Suppl. 01) S11-S16
• 8 Reddi D. Preventing chronic postoperative pain. Anaesthesia 2016; 71 (Suppl. 01) 64-71
• 9 Fonseca PRB, Gatto BEO, Tondato VA. Post-trauma and postoperative painful neuropathy. Rev Dor 2016; 17 (Suppl. 01) S59-62
• 10 Bartoszewski N, Parnes N. Rotator cuff injuries. JAAPA 2018; 31 (04) 49-50
• 11 Liu P. Therapeutic Effect of Single-row Technique and No-compression Sputum in the Treatment of Post Small and Medium Rotator Cuff Injury under Shoulder Arthroscopy. J Clin Nurs Res 2019; 3 (06) 37-41
• 12 Porto FMB, Alves MW, Andrade ALL. Avaliação de pacientes submetidos à sutura do manguito rotador com a técnica de Masson-Allen modificada. Acta Ortop Bras 2013; 21 (03) 167-179
• 13 Carvalho CD, Cohen C, Belangero PS. et al. Partial rotator cuff injury in athletes: bursal or articular?. Rev Bras Ortop 2015; 50 (04) 416-421
• 14 Tenor Júnior AC, de Lima JA, de Vasconcelos IT, da Costa MP, Filho RB, Ribeiro FR. Low-term results from non-conventional partial arthroplasty for treating rotator cuff arthroplasthy. Rev Bras Ortop 2015; 50 (03) 324-330
• 15 Silva AC, Ferreira J. Corpos no “limite” e risco à saúde na musculação: etnografia sobre dores agudas e crônicas. Interface (Botucatu) 2017; 21 (06) 141-151
• 16 Fernandes MR, Barbosa MA, Sousa ALL, Ramos GC. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II. Rev Bras Reumatol 2012; 52 (04) 616-622
• 17 Pereira RJ, Munechika M, Sakata RK. Tratamento da dor após procedimento cirúrgico ambulatorial. Rev Dor 2013; 14 (01) 61-67
• 18 Ramos CH, Sallum JS, Sobania RL. et al. Resultados do tratamento artroscópico das rupturas do manguito rotador. Acta Ortop Bras 2010; 18 (01) 15-18
• 19 Carvalho AL, Martinelli F, Tramujas L. Baggio Mo, Crocetta MS, Martins RO. Lesões do manguito rotador e fatores associados à reoperação. Rev Bras Ortop 2016; 51 (03) 298-302
• 20 Miyazaki NA, Silva LA, Santos PD, Checchia SL, Cohen C, Giora TSB. Avaliação dos resultados do tratamento cirúrgico artroscópico das lesões do manguito rotador em pacientes com 65 anos ou mais. Rev Bras Ortop 2015; 50 (03) 305-311
• 21 Granovsky Y, Yarnitsky D. Personalized pain medicine: the clinical value of psychophysical assessment of pain modulation profile. Rambam Maimonides Med J 2013; 4 (04) e0024
• 22 Bernaba M, Johnson KA, Kong JT, Mackey S. Conditioned pain modulation is minimally influenced by cognitive evaluation or imagery of the conditioning stimulus. J Pain Res 2014; 7 (07) 689-697
• 23 Goubert D, Danneels L, Cagnie B. et al. Effect of Pain Induction or Pain Reduction on Conditioned Pain Modulation in Adults: A Systematic Review. Pain Pract 2015; 15 (08) 765-777
• 24 Coffeen U, Simón K, Mercado F. et al. Procesamiento central del dolor neuropático: una aproximación integrativa. Salud Ment 2012; 35 (05) 367-374
• 25 Maitra S, Baidya DK, Bhattacharjee S, Som A. Gabapentina e pregabalina no período perioperatório em cirurgia cardíaca: uma revisão sistemática e metanálise. Rev Bras Anestesiol 2017; 67 (03) 294-304
• 26 Schmidt AP, Schmidt SRG. O comportamento dos canais iônicos controlados por diferença de potencial elétrico e dos receptores do tipo Toll na fisiopatologia da dor neuropática. Rev Dor 2016; 17 (01) 43-45
• 27 Silva RF, Rezende DC, Ribeiro JM. et al. Associação de clonidina e ropivacaína no bloqueio de plexo braquial para artroscopia de ombro. Rev Bras Anestesiol 2016; 66 (04) 335-340
• 28 Godinho GG, França FO, Freitas JMA. et al. Resultado do tratamento cirúrgico artroscópico das rupturas do manguito rotador do ombro. Rev Bras Ortop 2015; 50 (01) 89-93
• 29 Salvador E, Aliaga L. Combinación de opioides. Rev Soc Esp Dolor 2016; 23 (03) 159-163