Determinants of outcome for patients undergoing lumbar discectomy: a pilot study.

Hdl Handle:
http://hdl.handle.net/10147/200262
Title:
Determinants of outcome for patients undergoing lumbar discectomy: a pilot study.
Authors:
Hickey, Oonagh T; Burke, Siun M; Hafeez, Parvais; Mudrakouski, Alexander L; Hayes, Ivan D; Keohane, Catherine; Butler, Mark A; Shorten, George D
Affiliation:
Department of Anaesthesia, Cork University Hospital, Cork City, Ireland. oonaghhickey@yahoo.co.uk
Citation:
Determinants of outcome for patients undergoing lumbar discectomy: a pilot study. 2010, 27 (8):696-701 Eur J Anaesthesiol
Journal:
European journal of anaesthesiology
Issue Date:
Aug-2010
URI:
http://hdl.handle.net/10147/200262
DOI:
10.1097/EJA.0b013e32833b46dc
PubMed ID:
20520554
Abstract:
One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus.; A prospective observational pilot study of patients (n = 39) was performed. Quantitative sensory testing, visual analogue scales for anxiety and pain, the Hospital Anxiety and Depression (HADS) Scale and the McGill Pain Questionnaire were completed, and serum nitric oxide metabolites were measured perioperatively. Excised disc tissue was examined histologically, and immunohistochemistry for phospholipase A2 was performed.; Ten patients (26%) had an unsatisfactory outcome. Those with a satisfactory outcome had greater preoperative pain perception thresholds over the affected dermatome, which decreased by 2 months postoperatively. These patients also demonstrated a decrease in nitric oxide metabolites from preoperatively to 18 h postoperatively. Greater preoperative HADS scores, and greater pain intensity 4 h and 24 h postoperatively were associated with an unsatisfactory outcome.; Patients with a satisfactory outcome demonstrate a decrease in pain perception thresholds and plasma concentration of stable nitric oxide metabolites during the perioperative period. Patients with an unsatisfactory outcome following lumbar discectomy experience greater preoperative anxiety and greater pain during the early postoperative period. These findings justify a larger prospective observational study.
Item Type:
Article
Language:
en
Description:
BACKGROUND AND OBJECTIVE: One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus. METHODS: A prospective observational pilot study of patients (n = 39) was performed. Quantitative sensory testing, visual analogue scales for anxiety and pain, the Hospital Anxiety and Depression (HADS) Scale and the McGill Pain Questionnaire were completed, and serum nitric oxide metabolites were measured perioperatively. Excised disc tissue was examined histologically, and immunohistochemistry for phospholipase A2 was performed. RESULTS: Ten patients (26%) had an unsatisfactory outcome. Those with a satisfactory outcome had greater preoperative pain perception thresholds over the affected dermatome, which decreased by 2 months postoperatively. These patients also demonstrated a decrease in nitric oxide metabolites from preoperatively to 18 h postoperatively. Greater preoperative HADS scores, and greater pain intensity 4 h and 24 h postoperatively were associated with an unsatisfactory outcome. CONCLUSION: Patients with a satisfactory outcome demonstrate a decrease in pain perception thresholds and plasma concentration of stable nitric oxide metabolites during the perioperative period. Patients with an unsatisfactory outcome following lumbar discectomy experience greater preoperative anxiety and greater pain during the early postoperative period. These findings justify a larger prospective observational study.
MeSH:
Adult; Diskectomy; Double-Blind Method; Female; Humans; Low Back Pain; Lumbar Vertebrae; Male; Middle Aged; Pain Measurement; Pain Threshold; Pain, Postoperative; Pilot Projects; Preoperative Care; Prospective Studies; Treatment Outcome; Young Adult
ISSN:
1365-2346

Full metadata record

DC FieldValue Language
dc.contributor.authorHickey, Oonagh Ten
dc.contributor.authorBurke, Siun Men
dc.contributor.authorHafeez, Parvaisen
dc.contributor.authorMudrakouski, Alexander Len
dc.contributor.authorHayes, Ivan Den
dc.contributor.authorKeohane, Catherineen
dc.contributor.authorButler, Mark Aen
dc.contributor.authorShorten, George Den
dc.date.accessioned2012-01-05T12:36:08Z-
dc.date.available2012-01-05T12:36:08Z-
dc.date.issued2010-08-
dc.identifier.citationDeterminants of outcome for patients undergoing lumbar discectomy: a pilot study. 2010, 27 (8):696-701 Eur J Anaesthesiolen
dc.identifier.issn1365-2346-
dc.identifier.pmid20520554-
dc.identifier.doi10.1097/EJA.0b013e32833b46dc-
dc.identifier.urihttp://hdl.handle.net/10147/200262-
dc.descriptionBACKGROUND AND OBJECTIVE: One-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus. METHODS: A prospective observational pilot study of patients (n = 39) was performed. Quantitative sensory testing, visual analogue scales for anxiety and pain, the Hospital Anxiety and Depression (HADS) Scale and the McGill Pain Questionnaire were completed, and serum nitric oxide metabolites were measured perioperatively. Excised disc tissue was examined histologically, and immunohistochemistry for phospholipase A2 was performed. RESULTS: Ten patients (26%) had an unsatisfactory outcome. Those with a satisfactory outcome had greater preoperative pain perception thresholds over the affected dermatome, which decreased by 2 months postoperatively. These patients also demonstrated a decrease in nitric oxide metabolites from preoperatively to 18 h postoperatively. Greater preoperative HADS scores, and greater pain intensity 4 h and 24 h postoperatively were associated with an unsatisfactory outcome. CONCLUSION: Patients with a satisfactory outcome demonstrate a decrease in pain perception thresholds and plasma concentration of stable nitric oxide metabolites during the perioperative period. Patients with an unsatisfactory outcome following lumbar discectomy experience greater preoperative anxiety and greater pain during the early postoperative period. These findings justify a larger prospective observational study.en
dc.description.abstractOne-third of patients who undergo lumbar discectomy continue to suffer from persistent pain postoperatively. Greater preoperative warmth thresholds and greater preoperative cerebrospinal fluid concentrations of stable serum nitric oxide metabolites are associated with a worse outcome. The principal objective of this study was to examine the relationship between patient outcome (defined using the Modified Stauffer-Coventry evaluating criteria) and preoperative pain perception threshold to an electrical stimulus.-
dc.description.abstractA prospective observational pilot study of patients (n = 39) was performed. Quantitative sensory testing, visual analogue scales for anxiety and pain, the Hospital Anxiety and Depression (HADS) Scale and the McGill Pain Questionnaire were completed, and serum nitric oxide metabolites were measured perioperatively. Excised disc tissue was examined histologically, and immunohistochemistry for phospholipase A2 was performed.-
dc.description.abstractTen patients (26%) had an unsatisfactory outcome. Those with a satisfactory outcome had greater preoperative pain perception thresholds over the affected dermatome, which decreased by 2 months postoperatively. These patients also demonstrated a decrease in nitric oxide metabolites from preoperatively to 18 h postoperatively. Greater preoperative HADS scores, and greater pain intensity 4 h and 24 h postoperatively were associated with an unsatisfactory outcome.-
dc.description.abstractPatients with a satisfactory outcome demonstrate a decrease in pain perception thresholds and plasma concentration of stable nitric oxide metabolites during the perioperative period. Patients with an unsatisfactory outcome following lumbar discectomy experience greater preoperative anxiety and greater pain during the early postoperative period. These findings justify a larger prospective observational study.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshDiskectomy-
dc.subject.meshDouble-Blind Method-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLow Back Pain-
dc.subject.meshLumbar Vertebrae-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPain Measurement-
dc.subject.meshPain Threshold-
dc.subject.meshPain, Postoperative-
dc.subject.meshPilot Projects-
dc.subject.meshPreoperative Care-
dc.subject.meshProspective Studies-
dc.subject.meshTreatment Outcome-
dc.subject.meshYoung Adult-
dc.titleDeterminants of outcome for patients undergoing lumbar discectomy: a pilot study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Anaesthesia, Cork University Hospital, Cork City, Ireland. oonaghhickey@yahoo.co.uken
dc.identifier.journalEuropean journal of anaesthesiologyen
dc.description.provinceMunster-

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