BACKGROUND Treatment of postoperative pain remains a significant clinical problem, and prediction of patients with a risk of higher postoperative pain levels is an important focus. We aimed to identify patients undergoing total hip arthroplasty (THA) with risk of higher pain levels at 24 h postoperatively by using four simple and easily available clinical tools. METHODS This prospective observational cohort study included 102 patients having THA at Zealand University Hospital in Denmark. The following predictive tools were investigated for identifying patients with higher postoperative pain levels at 24 h postoperatively, both at rest and during mobilization: preoperative pain by peripheral venous cannulation (PVC) (dichotomized according to numerical rating scale pain ≤ 2/> 2 (PVC-Low/PVC-High) (primary outcome); the post anesthesia care unit (PACU) nurses' expectations of patients pain levels; patients early pain levels at the PACU; and patients own forecast of postoperative pain levels. The Mann-Whitney U test was used to analyze comparisons between prediction groups. For the primary outcome we considered a p-value < 0.01 as statistically significant and for other outcomes a p-value of 0.05. RESULTS We found no significant differences between the PVC groups for pain during mobilization at 24-h postoperatively: PVC-Low: 6 (4-8) (median, (IQR)) versus PVC-High: 7 (5-8) (median, (IQR)), p = 0.10; and for pain at rest: PVC-Low 2 (0-3) (median, (IQR)) versus PVC-High 3 (2-5) (median, (IQR)), p = 0.12. Other comparisons performed between predictive groups did not differ significantly. CONCLUSIONS In this prospective cohort study of 102 THA patients, we did not find that preoperative pain by PVC, when using a cut-off point of NRS ≤ 2, were able to predict postoperative pain at 24 h postoperatively. Neither did PACU nurses' prediction of pain, patients forecast of pain, nor did maximum pain levels at the PACU. TRIAL REGISTRATION Retrospectively registered 20th February 2018 at ClinicalTrials.gov (NCT03439566).

中文翻译：

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使用四种不同的临床工具作为全髋关节置换术后疼痛的预测因子：一项前瞻性队列研究。

背景技术术后疼痛的治疗仍然是重要的临床问题，对具有更高术后疼痛水平的风险的患者进行预测是重要的重点。我们的目标是通过使用四种简单易用的临床工具，在术后24 h识别接受全髋关节置换术（THA）并具有较高疼痛水平风险的患者。方法这项前瞻性观察性队列研究纳入了丹麦西兰大学医院的102例THA患者。研究人员研究了以下预测工具，以识别术后24小时，静息时和动员时具有更高术后疼痛水平的患者：外周静脉插管（PVC）术前疼痛（根据数字评分表疼痛≤2 /> 2分（PVC） -低/ PVC-高）（主要结果）；麻醉后护理单位（PACU）对患者疼痛程度的期望；患者在PACU的早期疼痛程度；并且患者对术后疼痛程度有自己的预测。Mann-Whitney U检验用于分析预测组之间的比较。对于主要结局，我们认为p值<0.01具有统计显着性，对于其他结局，我们认为p值为0.05。结果我们发现在术后24小时动员期间，PVC组在疼痛方面无显着差异：PVC低（6（4-8）（中位数（IQR））与PVC高（7（5-8）（中位数）） ，（IQR）），p = 0.10；对于休息时的疼痛：PVC低2（0-3）（中位数（IQR））与PVC高3（2-5）（中位数（IQR）），p = 0.12。预测组之间进行的其他比较没有显着差异。结论在这项针对102名THA患者的前瞻性队列研究中，我们没有发现使用NRS≤2的分界点时，PVC术前疼痛能够预测术后24 h的术后疼痛。PACU护士对疼痛的预测，患者对疼痛的预测，PACU的最大疼痛水平也没有。试验注册于2018年2月20日在ClinicalTrials.gov上进行追溯注册（NCT03439566）。