Abstract:

Objective To investigate the effect of diabetes on acute and chronic pain after unilateral total knee replacement. Methods The institutional review board of General Hospital of Southern Theater Command of PLA approved the study protocol. A total of 60 patients who underwent unilateral total knee replacement in the Gen⁃ eral Hospital of Southern Theater Command of PLA from October 2019 to March 2021 were selected for this study and divided into two groups，including normal control group（Group NC，n=30）and diabetic group（Group D，n= 30）. Visual analogue scale，Mechanical withdrawal threshold，and the consumption of sufentanil were recorded and compared at different time points. The serum levels of TNF ⁃ α，IL ⁃6，and IL ⁃10 before operation and three hours after operation were measured and compared between the two groups，the incidence and intensity of chronic pain after operation was inquired and recorded at 3rd，and 6th months after operation. Results Compared with Group NC，mechanical withdrawal threshold before operation，at 3，6，24，48，72 hours after operation in Group D was significantly lower（P < 0.05），VAS of rest/exercise pain at 3，6，12，24，48，72 hours after operation in Group D was significantly higher（P < 0.05），the consumption of sufentanil in Group D increased significantly at 3， 6 12，48 and 72 hours after operation（P < 0.05）and the total number of compressions and the number of effective compressions of the PCA analgesic pump increased significantly within 72 hours after operation（P < 0.05）. There was no significant difference in serum levels of IL⁃6，TNF⁃αand IL⁃10 before and 3h after operation between the two groups. At 6th months after operation，the incidence and intensity of postoperative chronic pain in Group D was significantly higher（P < 0.05）. Conclusions The intensity of acute pain after total knee replacement and the inci⁃ dence and intensity of chronic pain in diabetic patients are higher than non⁃diabetic patients.

Key words:

diabetes, total knee replacement, visual analogue scale, mechanical withdrawal thresh? old, postoperative pain