A retrospective analysis of the effects of different analgesics on the pain of patients with traumatic thoracolumbar fractures in the peri-treatment period

Journal of Orthopaedic Surgery and Research, 2021 · DOI: https://doi.org/10.1186/s13018-021-02401-w · Published: May 5, 2021

Pain Management Orthopedics Musculoskeletal Medicine

Simple Explanation

This study looked at how different pain medications affect pain and recovery after surgery for thoracolumbar fractures. Patients were given acetaminophen dihydrocodeine, celecoxib, or etoricoxib. The study measured pain levels, chronic pain incidence, and functional recovery using questionnaires and follow-up calls. The goal was to determine the best pain management approach for these fractures. The researchers found that while acetaminophen dihydrocodeine was effective for acute pain, it was associated with a higher risk of chronic pain and worse long-term recovery compared to celecoxib and etoricoxib.

Study Duration

November 2009 to January 2019

Participants

719 patients with thoracolumbar fractures

Evidence Level

Not specified

Key Findings

1
Severe spinal cord injury and peri-treatment use of acetaminophen dihydrocodeine were risk factors for postoperative chronic pain.
2
Patients in the acetaminophen dihydrocodeine group had longer analgesic use, higher pain scores, a higher incidence of chronic pain, and a higher ODI index.
3
Peri-treatment pain score was correlated with the severity of postoperative chronic pain.

Research Summary

This study analyzed the effects of different analgesics on pain and functional recovery in patients with thoracolumbar fractures. Patients were divided into acetaminophen dihydrocodeine, celecoxib, and etoricoxib groups. The study found that acetaminophen dihydrocodeine, while effective for acute pain relief, was associated with a higher risk of chronic pain and worse functional outcomes compared to celecoxib and etoricoxib. The conclusion suggests combining strong analgesics with anti-inflammatory analgesics for patients with severe preoperative pain to reduce postoperative chronic pain and improve rehabilitation.

Practical Implications

Personalized Pain Management

Tailor analgesic selection based on preoperative pain severity and risk factors for chronic pain.

Combination Therapy

Consider combining strong analgesics with anti-inflammatory drugs to optimize pain relief and functional recovery.

Monitoring and Follow-up

Closely monitor patients on acetaminophen dihydrocodeine for the development of chronic pain.

Study Limitations

1
Lifestyle habits were difficult to define and categorize.
2
Difficult to measure pain sensitivity prior to this study.
3
Retrospective analysis, so the results of this study can only be used as a basic understanding

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