Journal
PAIN MANAGEMENT
Volume 7, Issue 5, Pages 391-403Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/pmt-2017-0023
Keywords
chronic postsurgical pain; conditioned pain modulation effect; heart rate variability; pain catastrophizing; temporal summation; total knee replacement
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This study explored whether nociceptive (NS) and autonomic nervous system (ANS) dysregulation and psychological distress were predictive of pain 6 months after primary total knee replacement. Patients & methods: ANS and NS regulation, psychological distress and self-reported pain, stiffness and function were evaluated preoperatively in 56 patients. Pain severity measured 6 months after surgery was used as the primary outcome in an analysis of covariance model. Results: The data of 47 patients (85.5%) could be analyzed. Postoperative pain severity 6 months after surgery was significantly associated with reduced heart rate variability and tended to be related to a lower conditioned pain modulation effect, but the latter only in females. Conclusion: Due to the small sample size the results must be interpreted with caution. A dysregulation of ANS and NS may be predictive of pain severity 6 months after total knee replacement. The impact of the conditioned pain modulation effect could be sex specific.
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