Effects of different Analgesics on Pain with Traumatic Thora
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A Study was conducted to analyze and compare the effects of peri-treatment analgesics on acute and chronic pain and postoperative functional recovery of patients with thoracolumbar fractures, so as to guide the clinical drug use.

719 patients with thoracolumbar fractures were classified into three groups: acetaminophen dihydrocodeine, celecoxib, and etoricoxib. The key measures were the degree of postoperative pain (VAS), the prevalence of chronic pain, and postoperative functional recovery (ODI and Japanese Orthopedics Association score (JOA), all of which were continuously monitored via long-term telephone follow-up.

To better understand the risk factors for chronic pain, researchers conducted a correlation analysis of the ODI-pain score, peri-treatment VAS score, and ODI index, as well as a bivariate regression analysis.

Results:
--Regression analysis showed that severe spinal cord injury and peri-treatment use of acetaminophen dihydrocodeine were both one of the risk factors for postoperative chronic pain.

--But there were no statistically conspicuous differences in basic characteristics, preoperative injury, and intraoperative conditions.

--Compared with the other two groups, patients in the acetaminophen dihydrocodeine group had longer peri-therapeutic analgesic use, higher pain-related scores (VAS 1 day preoperatively, VAS 1 month postoperatively, and ODI-pain 1 year postoperatively), higher VAS variation, higher incidence of chronic pain 1 year after surgery, and higher ODI index. And other ODI items and JOA assessments showed no statistically significant differences.

--In addition, the correlation analysis showed that the peri-treatment pain score was correlated with the severity of postoperative chronic pain.

To summarize, while acetaminophen dihydrocodeine has a strong peri-treatment analgesic effect, it is still important to combine analgesics with different mechanisms of action for patients with extreme preoperative pain of thoracolumbar fracture, in order to reduce the occurrence of postoperative chronic pain and improve the quality of postoperative recovery.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02401-w
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