医学
关节置换术
全髋关节置换术
焦虑
麻醉
物理疗法
外科
精神科
作者
Fu‐Shan Xue,Wen H. Yang,Xin Li
标识
DOI:10.1016/j.bja.2023.10.007
摘要
Editor—In a randomised controlled observer-blinded trial of 112 patients undergoing primary total hip arthroplasty under spinal anaesthesia, Kukreja and colleagues 1 Kukreja P. Uppal V. Kofskey A.M. et al. Quality of recovery after pericapsular nerve group (PENG) block for primary total hip arthroplasty under spinal anaesthesia: a randomised controlled observer-blinded trial. Br J Anaesth. 2023; 130: 773-779 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar showed that the addition of a pericapsular nerve group (PENG) block to a multimodal analgesia strategy significantly improved the quality of early postoperative recovery assessed by the Quality of Recovery-15 questionnaire (QoR-15) and reduced postoperative opioid requirements. According to Figure 3 of their paper, we noted that among five domains of QoR-15, postoperative improvements of both physical comfort and emotional state were the most significant. The authors provided the baseline characteristics of subjects in their Table 1, but they did not clearly state whether preoperative psychological and functional status were assessed. Available data indicate that psychological disorders including depression, somatisation and anxiety, and poor functional status including low physical activity and disability are common among patients undergoing total hip arthroplasty and can negatively affect early postoperative outcomes of functional recovery. 2 O'Connor J.P. Holden P. Gagnier J.J. Systematic review: preoperative psychological factors and total hip arthroplasty outcomes. J Orthop Surg Res. 2022; 17: 457 Crossref Scopus (3) Google Scholar , 3 Hewlett-Smith N.A. Pope R.P. Hing W.A. Simas V.P. Furness J.W. Patient and surgical prognostic factors for inpatient functional recovery following THA and TKA: a prospective cohort study. J Orthop Surg Res. 2020; 15: 360 Crossref PubMed Scopus (8) Google Scholar , 4 Oosting E. Hoogeboom T.J. Appelman-de Vries S.A. Swets A. Dronkers J.J. van Meeteren N.L. Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study. Disabil Rehabil. 2016; 38: 1243-1249 Crossref PubMed Scopus (22) Google Scholar Although this is a randomised controlled trial and there should be no significant differences in these preoperative factors between groups that might affect postoperative functional recovery, we are still concerned that significant between-group imbalances could have biased the findings on the quality of early postoperative recovery.
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