Establishment of a new treatment system by elucidating the mechanism of intractable protracted postoperative pain

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K16691
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Orthopaedic surgery
• Research Institution: Okayama University
• Principal Investigator: Tetsunaga Tomoko 岡山大学, 大学病院, 助教 (70601384)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 人工膝関節置換術 / 術後遷延痛 / 慢性疼痛 / 集学的治療 / 神経障害性疼痛

Outline of Final Research Achievements

We conducted an epidemiological analysis of postoperative pain in patients who underwent total knee arthroplasty, and found that approximately 20% of patients had a predisposition to neuropathic pain and tended to be depressed. fMRI was performed on patients with postoperative protracted pain, but no characteristic findings were observed in neuropathic pain. For patients with postoperative protracted pain, treatment with oral pregabalin and multidisciplinary treatment were performed, and the therapeutic effects were examined. Pain NRS was significantly reduced before and after treatment. Depressive tendency and catastrophic thinking were also significantly improved before and after treatment. We performed fMRI on some patients, but no specific changes were observed before and after treatment.

Free Research Field

整形外科

Academic Significance and Societal Importance of the Research Achievements

人工膝関節置換術後の遷延痛で悩まれている患者は多く存在する。しかしながら、有効な治療法が確立されておらず、病院を転々と受診していることがある。本研究では術後遷延痛患者における神経障害性疼痛の割合を明らかにし、神経障害性疼痛に対する薬物療法と集学的治療を行った。その結果、ある一定の割合で疼痛の軽減が得られ、日常生活に戻れる症例を認めた。このような患者に対する治療においては薬物療法に加え、集学的治療を行うことが必要であることが明らかになった。